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SAN JOAQUIN COUNTY <br /> ENVIRC AMENTAL HEALTH DEPART JT Page 1 <br /> 3614 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD <br /> <br /> 005 <br /> KRAGEN AUTO ,ARTS #1482 RE : KRAGEN AUTO PARTS #1482 <br /> 1905 ASTON AVE 309 W CHARTER WAY <br /> CARLSBAD, CA P2008 STOCKTON, CA 95206 <br /> OWNER : CSK AUTO INC <br /> Date Health Amount <br /> Program Descript on <br /> Invoice# IN0128414--Date of Invoice 1/24/2005 IIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII I IIIIIIII IIII IIIIII VIII IIIIIN <br /> 1/24/2005 2220 SM HW PEN <5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAzMAT FEE $ 270.00 <br /> 1/24/2005 2399 UNIFIEC PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 494.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Periodl 494.00 <br /> 4 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 2 2005 <br /> SAENVENVIROOAQUIN NMENTAL <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 Fes 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 /> 5255 rpt <br />