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ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600 E MAIN STREET - <br /> STOCKTON, CA 95202 I. , <br /> Phone: (209) 468-3420 <br /> INVOICE Q Account ID AR 0017429 <br /> �v O Facility ID FA0010429 <br /> Date Printed F 5/27/2009 <br /> DOUBLE A TRUCK SVC RE : DOUBLE A TRUCK SVC <br /> PO BOX 1402 1675 W CHARTER WAY D <br /> DISCOVERY BAY, CA 94505-7402 STOCKTON, CA 95206 <br /> OWNER : ANDREW SALMERON SR <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0184417--Date of Invoice: 1/29/2009 1111111111 IN 11111111111 IN 1111 <br /> 1/29/2009 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 285.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mal Program Penalty Fee $ 28.50 <br /> 4/15/2009 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total forthis Invoice $ 763.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 763.50 <br /> � r lap at u .P <br /> �A�v mayy: n <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 /> 5254rpt <br />