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v�.� �v� V•• VVI\11 <br /> ENVIRONMENTAL HEALTH DEPARTM • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017448 <br /> Facility ID FA0010448 <br /> Date Printed 7/16/2004 <br /> COTTMAN TRANSMISSIONS RE : COTTMAN TRANSMISSIONS <br /> 4629 WEST LN #7 4629 WEST LN 7 <br /> STOCKTON, CA 95210 STOCKTON, CA 95210 <br /> OWNER : BAUGUSS,JOHN <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0116023---Date of Invoice: 214/2004 IIIIIIIIIIIIII VIIIIIIIIIIVIIVIVIIIVIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 100.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/21/2004 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> 4/15/2004 9994 PERMIT FEE PENALTY $ 200.00 <br /> 5/20/2004 9999 PAYMENT ($ 324.00) <br /> Total for this Invoice $ 210.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period 210.00 <br /> PAYMENT <br /> RECEIVED <br /> JUL 16 2004 <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 OES 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 /> 5255.rpt <br />