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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE ���,'2 Account ID AR0035033 <br /> Facility ID FFA0019671 <br /> Date Printed 4/28/2011 <br /> ALL PRO PERFORMANCE RE : ALL PRO PERFORMANCE <br /> 820 S CALIFORNIA ST 820 S AMERICAN ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : RUBENRUBALCAVA <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0213728—•Date of Invoice: 1131/2011 IIIIIIII IIIIII IIIIIIII IIIIIIIIII VIII VIIIIIIIIII�IIIIII�IIIIIIIiI IIIIII VIII IIII IIII <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 100.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/26/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2011 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> Total for this Invoicel $ 159.00 <br /> Payment Due Date 3/212011 <br /> TOTAL DUE this Billing Period $ 159.00 <br /> r <br /> P T <br /> Delinquent charges <br /> will be forwarded to <br /> oar L F CtT R C N 5 <br /> itr W day& - <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 /> 52i4.rpt <br />