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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTI' — 'T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> <br /> INVOICE Account ID nRoo,sBss <br /> Facility 10 7FA000 8865 <br /> LMMMMEMMMMMUMM <br /> Date Pnnted 1/30/2006 <br /> COUNTRY NISSAN RE : COUNTRY NISSAN <br /> 1515 N MAIN ST 1515 N MAIN ST <br /> MANTECA, CA 95336 MANTECA, CA 95336 <br /> OWNER : VINTAGE INVESTMENTS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142852--Date of Invoice: 1/27/2006 11111111111111111111 IN IIIII IIIII 111111111111111 IN IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 315.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 539.00 <br /> Payment Due Date <br /> TOTAL DUE this Billing Period $$ /_5 <br /> PAY fV,'F-NT <br /> RECEIVED <br /> FEB 17 200b <br /> SAN JOAOUIN CCUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHO' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OES/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 />