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ENVIRONMENTAL HEALTH DEPARTIV 'T Page 1 <br /> 304.E .VEBER AVE -3RD FLOOR <br /> STOCKPhone: ON,209 46 95202 COPY <br /> Phone: (209 468-3420 <br /> INVOICE Account ID AR0017470 <br /> Facility ID FA0010470 <br /> Date Printed 1/26/2007 <br /> Immoommommommma <br /> ELEGANT SURFACES RE : ELEGANT SURFACES <br /> 551 CARNEGIE ST 551 CARNEGIE ST <br /> MANTECA, CA 95337 MANTECA, CA 95337 <br /> OWNER : POLIMENO,JOHN <br /> Date Health <br /> Program Descrip6nn Amuuni <br /> Invoice# ING156887—Date of Invoice: 1/25/2007 IIIIIIII IIIIIIIIIIIIIIIIIII VIIIVII IIIIIIIIIIIIIIIIIIII(IIIIIIII(IIIIIIIIII IIIIIIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 315.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 645.00 <br /> Payment Due Date 2/26/2007 <br /> TOTAL DUE this Billing Period $ 545.00 <br /> YXL <br /> :NAL TY OWINC-7 <br /> PAYMENT <br /> R�ECEIVED <br /> tr"" 2007 <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/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 />