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SAN JOAQUIN COUNTY Page1 <br /> ENVIRONMENTAL HEALTH DEPARTMI""T i <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0025022 <br /> Facility ID FA0014715 <br /> P�- D 0 s1 <br /> 'q-%-I a-S Date Panted 2/5/2004 <br /> a,.�. 5i4•� <br /> OLYMPIC TUNE RE : OLYMPIC TUNE <br /> 1026 BLACK DIAMOND WAY 1026 BLACK DIAMOND WAY <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : LOUIE J SOARES <br /> Date Health Amount <br /> Prooram Description <br /> Invoice# IN0117516--Date of invoice: 21412004 <br /> 2/4/2004 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 300.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for thislnvolce $ 524.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE thiPAYMENT <br /> s Billing Period $ 52 0 <br /> RECOV D <br /> MAR 2 2 2004 <br /> SAN JOAQUIN COUNTf <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For DES I HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />