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iMwuffv t,VUNI y <br /> EN'/ ONMEN SAL HEALTH DEPARTMF`T Page 1 <br /> 304 E NEBER AVE - 3 .D FLOOR <br /> STOPhone: <br /> :TON,(209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account to AR0024355 <br /> Facility ID FA00 4433 <br /> LMMMMMEWAMMMA <br /> Date Printed 1/30/2006 <br /> WHEEL WORKS RE : WHEEL WORKS <br /> 802 S FIRST ST 420 W LODI AVE <br /> SAN JOSE, CA 95110 LODI, CA 95240 <br /> OWNER : TIRES PLUS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0144360---Date of Invoice: 1/27/2006 1111111111111111111111111111111111111111111111111111111111 <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 270.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 494.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 494.00 <br /> r-�y <br /> �F�M�NT <br /> FF-B Ep <br /> v,, 13 <br /> H FNyq°pro <br /> ACTH ON,NFCOUjt,/Y <br /> Please rnake 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 /> 4`4 rpt <br />