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JMIY JVMWV11N VVUI.1 1 Page , <br /> ENVIRONMENTAL HEALTH DEPARTMIF <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE qoC Account to ARoo,szao <br /> Facility ID FA0009240 <br /> Date Printed F 4/28/2010 <br /> LUMMEMENNNOMEM <br /> PATEL, DIMPLE & HINA RE : ELITE CLEANERS <br /> ELITE CLEANERS 3201 W BENJAMIN HOLT DR STE 119 <br /> <br /> <br /> OWNER : PATEL, DIMPLE & HINA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0197704—Date of Invoice: 2/2/2010 I IIIIIII IIII III VIII VIII VIII VIII VIII VIII VIII Ilill VIII IIII IIII VIII IIII IIII <br /> 2/1/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 255.00 <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 $ 25'50 <br /> 4/15/2010 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total ror this Invoice $ 755.50 <br /> Payment Due Date 3/4/2010 <br /> . - TOTAL DUE this Billing Period $ 755.50 <br /> Delinquent charges <br /> will be forwarded to <br /> COLL .a n Ct,`A8 <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/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 m <br />