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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM^"T <br />600 E MAIN STREET <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br /> <br /> <br /> <br /> <br />Page 1 <br />Account ID <br />AR0034158 <br />Facility ID <br />FA0019193 <br />Date Printed <br />1/29/2009 <br />RE: SANBORN CHEVROLET PROLUBE SHOP <br />1190 S CHEROKEE LN <br />LODI, CA 95240 <br />OWNER: SANBORN CHEVROLET INC <br />Date Health <br />Program Description Amount <br />Invoice # IN0187142 --- Date of Invoice : 1/29/2009 <br />1/29/2009 2228 GEN 25<50 TONS PERMIT <br />1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />11111111111111111111 IN 111111111111111 IN <br />$ 1,911.00 <br />$ 24.00 <br />Total for this Invoicel $ 1,935.00 <br />Payment Due Date 2/28/2009 <br />TOTAL DUE this Billing Period $ 1,935.00 <br />RECE� VE r <br />D <br />FEE 12 2009 <br />SAN JOAQUIN <br />ENVIRON <br />HEALTN DEPART NT <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />'enalties 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 thereafte <br />�251.rpt <br />