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SAN JOAQUIN COUNTY �( 1 <br /> ENVIRONMENTAL HEALTH DEPARTMtKT r ... Page 1 <br /> 600E MAIN STREET RECEIVED <br /> STOCKTON, CA 95202 <br /> INVOICE MAY 3 0 2012 Account ID AR0036736 <br /> ENVIRONMENTAL FacllltyID FA0020532 <br /> HEALTH DEPARTMENT <br /> IL / Date Printed 4/30/2012 <br /> AJ AUTO N EXPRESS LUBE RE : AJ AUTO N EXPRESS LUBE <br /> 428 N AIRPORT WAY 428 N AIRPORT WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : PARMINDER BINNING <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0226400--Date of Invoice: 1/30/2012 11111111 IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII VIII VIII 1111111111111 IIII IIII <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 100.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> Total for this Invoice $ 159.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 159.00 <br /> EPAS� DUE MAY 1. 4 2012 <br /> Delinquent chargEFOPERONMENT HEALTH <br /> EAL H <br /> will be forwarded toPERM <br /> COLLECTIONS <br /> S �� I <br /> in 30 days. � <br /> !ItJ 4 To A-) - iE�f'lZesS ZW OfiT N0 T / <br /> l IU �� mss N �G> �, z© I ► a PLC-PfS <br /> Lo Ute 4T TIS 4 S �' <br /> M GtNT�CT CS0 7-�d �J <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy This ST EMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For DES/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 />