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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART NT Page 1 <br /> E STREET <br /> ST <br /> STUCKTOTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE t� � Account to I AR0018276 <br /> MAR 1 3 2009 <br /> Facility ID F FA0011276 <br /> !r� ENVIRONMENT HEALTLMEMMMNWWMMEMH <br /> 5� PERMITISERVICES Date Printed F--3t-6/2-00-9---j <br /> SIMPLE DESIGNS MFG RE : SIMPLE DESIGNS MMECEIVED <br /> 1627 ARMY CT UNIT 1 ( X` 1627 ARMY CT 1 <br /> STOCKTON, CA 95206 O�l STOCKTON, CA 9520WR 17 2009 <br /> OWNER : SIMPLE DESIGNS MFQ JOAQUIN COUNTY <br /> OF EMERGENCY SER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0185427---Date of Invoice: 1/2912009 �111111111111111111111 HE 111111111111111111111111111111111111111111111111111111 IN <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 270.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forth is Invoice I $ 294.00 <br /> Payment Due Date 2128/2009 <br /> TOTAL DUE this Billing Period $ 294.00 <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 IDES/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 /> _S4 rpt <br />