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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMr"T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, 95202 COPY <br /> Phone:e: (209(209) 46 468-3420 <br /> INVOICE AccountlD —AR 0-0-16-046 <br /> Facility ID F FA0009046 <br /> Date Printed 1/26/2007 <br /> Imommomommoommi <br /> CALIFORNIA RADIATOR WORKS RE : CALIFORNIA RADIATOR WORKS <br /> 328 S CALIFORNIA ST 328 S CALIFORNIA ST <br /> STOCKTON, CA 95203-3502 STOCKTON, CA 95203-3520 <br /> OWNER : FRANK BROCKMAN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0156403—Date of Invoice: 1125/2007 IIIIIIIIIIIIIVIVIIIVIII VIIVIIIIIIIIIIIIIIIII VIII IIII IIIIII VIII IIII IIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 285.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 515.00 <br /> Payment Due Date 2125/2007 <br /> TOTAL DUE this Billing Period E� <br /> PAYMENT <br /> i <br /> RECEIVE=D <br /> FEB 2 ? Lou <br /> SAN JOkoUIN COUNTY <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 OES 1 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 /> 5254.rpt <br />