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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMt. wT v Page 1 <br /> 600 E MAIN STREET RECEIVED <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 MAR 13 2012 <br /> INVOICE SAN JOAQUINCOUNIY Account ID AR0016112 I <br /> OFFICE OF EMERGENCY SERVICES <br /> s <br /> Facility ID FA0009112 <br /> Date Printed 2129/2012 <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# IN0223175---Date of Invoice: 1/30/2012 IIIIIIIII III II II IIIIIIIIIV I VI IIIIIIIIIVI I I VIII III 11111 IN 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 212 912 01 2 <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 f added toallPermit Fees � For be a / ed at Fees —10% For all SERVICE FEES _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 's0 Days thereafter <br /> 5 1 rpt <br />