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SAN JOAQUIN COUNTY Page I <br /> ENVIRONMENTAL HEALTH DEPARTI►onrJT RECEIVED <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 MAR 13 2012 <br /> INVOICE SAN JOAQUIN COUNTY Account ID AR0016112 <br /> OFFICE OFEMERGENCYSERVICES -- — - <br /> Facility l0 FA0009112 <br /> Date Printed ( 2/29/2012 <br /> $4 <br /> MORLINO, MARCEL RE : FIRESTONE COMPLETE AUTO CARE#36J6 <br /> FIRESTONE COMPLETE AUTO CARE#36J6 940 N CENTRAL AVE <br /> <br /> <br /> OWNER : BRIDGESTONE RETAIL OPERATIONS <br /> Date Health <br /> Program Description Amount <br /> Invoice If IN0223175-•-Date of Invoice: 1/30/2012 111111111 IN <br /> 1/27/2012 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 85.00 <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 /> Total for this Invoice $ 347.00 <br /> Payment Due Date 2/29/2012 <br /> TOTAL DUE this Billing Period $ 347.00 <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 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 /> i4 rpt <br />