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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPART* 304 E WEBER AVE - 3RD FLOOR t ' STOCKTON, CA 95202 Phone: (209) 468-3420 INVOICE INTERSTATE TRUCK CTR - COLLISION DI PO BOX 6463 STOCKTON, CA 95206 Date Health Program Description Invoice # IN0116138 --Date of Invoice : 2/4/2004 2/4/2004 2220 SM HW GEN <5 TONS/YR 2/4/2004 2244 2004 HAZMAT FEE 242034 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE 0 Page 1 Acmunt ID FAR0018023 Faality ID FA0011023 Date Printed 2 5/2004 RE: INTERSTATE TRUCK CTR -COLLISION DI 641 S HARRISON ST STOCKTON. CA 95206 OWNER: JOHN PHILLIPS Amount PAYMENT RECEIVED FEB 2 7 2004 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT Penalties will be added to all Permit Fees For OES / HMMP Fees For all SERVICE FEES 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 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafte 5255.rpt S 200.00 S 330.00 $ 24.00 Total for this Invoice $ 7 554.00 Payment Due Date / 3/6/2004 TOTAL DUE this Billing Period i 'I$ 'S5410 PAYMENT RECEIVED FEB 2 7 2004 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT Penalties will be added to all Permit Fees For OES / HMMP Fees For all SERVICE FEES 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 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafte 5255.rpt