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0N14 JVMWU114 l UU1V I I Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET q u <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0031904 <br /> Facility ID FA00181 4— <br /> Date Printed 3/31/2010 <br /> D&M TRUCKING RE : D&M TRUCKING <br /> 3112 WALLACE AVE 1612 ALPINE RD <br /> STOCKTON, CA 95204 STOCKTON, CA 95205 <br /> OWNER : FRED COSTILLA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0200525---Date of Invoice: 212/2010 11111111111111111111 IN IN <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 85.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Totalfor this Invoice $ 142.50 <br /> Payment Due Date 31412010 <br /> TOTAL DUE this Billing Period $ 142.50 <br /> I7 � OU <br /> will be forna1P€ar-, EO <br /> 000-LEF, T15 <br /> in 30 days. <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 DES I 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 />