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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTN T <br /> 600 E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID ARootsoas <br /> Facility ID FA0009046 <br /> LUMMOMMMMEMOM <br /> Date Pnnted 1/28/2006 <br /> LEMEMENNOMMMME <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 /> l Program Description Amount <br /> Invoice# IN0170045---Date of Invoice: 1/2512008 (IIIIII(IIII(IIIIII VIII IIIIIIIIIVIIIIIIII VIII VIII VIIIIIII IIIIII V(((III IIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 285.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forthis Invoice $ 522.00 <br /> Payment Due Date 2/27/2008 <br /> —� — <br /> F--TOTAL DUE this Billing Period $ 522.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 6 2008 <br /> SAN JOAQUIN 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 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 /> 5254 rpt <br />