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ONIYpIVN(,(V IIV (.vvivr r Pa e 1 <br /> ENVIRONMENTAL HEALTH DEPARTMEl,'T g <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE VO Account ID ARoo 17766 <br /> Facility ID FA0010766 <br /> Date Printed 4/28/201 011 <br /> SPECIALIZED TRUCK SVC RE : SPECIALIZED TRUCK SVC <br /> PO BOX 8403 3665 E CHEROKEE RD <br /> STOCKTON, CA 95208-0403 STOCKTON, CA 95205 <br /> OWNER : DAVID RAY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0198130---Date of Invoice: 2/2/2010 IIIII (IIIIIIIIVI VAVIIIIIIII IIIVIIVIIIIIIIIIIIII IIIIII IIIII IN III <br /> 2/1/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 300.00 <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 $ 30.00 <br /> 4/15/2010 9994 PERMIT FEE PENALTY $ 213.00 <br /> r Total for this Invoice $ 805.00 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 805.00 <br /> rte °, <br /> Delin ,Lent changes <br /> Will be to <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.rpt <br />