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UJ /u/Jiinu U0:00 HM 115on FAX Na, 19163765372 P. 001/001 <br /> ,N JOAQUIN COUNTY <br /> IvViRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 68 E HAZELTON AVENUE <br /> STOCKTON, CA 95205. <br /> Phbne; (209) 468-3420 <br /> ' VO'C COPY Account ID AR0016961 <br /> , C//L/7S Facility ID FA0009961 <br /> Date Printed F 3/31/2015 <br /> 90A1 SVDW!Er % <br /> RE : CALIFORNIA STATE BLDG <br /> CALIFORNIA STATE BLDG 31 E CHANNEL ST 108 <br /> 31 E CHANNEL ST#108 STOCKTON, CA 95202 <br /> STOCKTON, CA 95202 <br /> OWNER : CALIFORNIA STATE BLDG <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0261168--Date of Invoice, 1/29/2015IIIIIIIIIIIIIIIIIVIIIVIIIIIIIIIIIUIIIIIIpII11I11VIIIVIIIIIIIIIpII1111111111111 <br /> 1/292015 1920 HMBP-Common Materials II $ 1I 10110.0101 <br /> 1/29/2015 2220 SM HW GEN c5 TONS(YR $ 213.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> 3/152015 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> Total forth',lnvolce $ 35B.00 <br /> 1 <br /> �.;L ^I^ �� it Payment Due Data 2/28/2015 <br /> WC--WOUL;AF fir-"..1A HE YOUR <br /> P,AYioiENT`rODAYI TOTAL DUE this Billing Period $ 358.00 <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 HMBP 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 Dave after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> Received Time—Apr, 9. -2015-10: 00AM---Na. 8484 <br /> 5254.rpt <br />