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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTII' 'T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOC <br /> (209)468-3420 <br /> INVOICE AccountlD AR0006259 <br /> Facility ID FA0005626 <br /> Date Printed /27/2007 <br /> x <br /> SANBORN CHEVROLET INC RE : SANBORN CHEVROLET INC <br /> PO BOX 1057 1210 S CHEROKEE LN <br /> LODI, CA 95241-1 D57 LODI, CA 95241 <br /> OWNER : SANBORN CHEVROLET INC <br /> Health <br /> Date PrnC- Dascri.Dtic in Amount <br /> Invoice# IN0156340---Date of Invoice: 1/25/2007 1111111 U111 III 11111 11111 11111 11111 1111�11111 11111 11111 11111 1111 111111 11111 IN!III <br /> 1/25/2007 2220 SM HW C EN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HA2 MAT FEE $ 405.00 <br /> 1/25/2007 2399 UNIFIED ROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2007 9987 Haz Mat Program Penalty Fee $ 40.50 <br /> Total for this Invoice $ 675.50 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 675.50 <br /> � r �n/T <br /> kk o: -- sgNAO R 4 200? <br /> �_ ^.'.:.„r AT "CCJ R f l ENV/RpN W OOUNTY <br /> PAYIAe-HMEN T, <br /> TC3OAY EALTy pEPgRTAL <br /> MENT <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/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 />