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06/03/2011 14:50 209464UI38 crvv+^�"` • '"� ""- <br /> SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME_ <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 L2 <br /> Phone: (209)4683420 <br /> INVOICE �`�� q¢ounuU AR0034518 <br /> Dale <br /> aPdnted FA06/201111 <br /> �ECD <br /> HARRELL, DAVID V RE : LODI MOTOR SPORTS JUN - <br /> 531 KANSAS AVE 847 N CLUFF AVE STE C 3 pp» <br /> MODESTO, CA 95354 LODI,CA 96240 <br /> SAN <br /> OWNER: HARRELL, DAVID V <br /> C MC OFEMERGEN� CySERVICES <br /> Date Meaah Amount <br /> Prog am Dascrlptbn �I aa <br /> Involoelr IN0213787---Dateoflnvaice: 1/3112011 I■.'�� � ��'��p01,Bp III) <br /> 1!26/2011 2244 2011 HAZMAT FEE S $5.00 <br /> 11262011 2390 UNIFIED PROGRAM FAC STATE SURCHARGE FEE 5 24'00 <br /> 1126/2011 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE E 25.00 <br /> 31202011 9967 Hai Mat Program Penalty Fee S 6'50 <br /> Tubl for thl6 lreoke S 142.50 <br /> UP <br /> PAST DUE <br /> �" �'Ll, DD rq <br /> TOTAL DUE this Billing Period $ 142.$0 <br /> SUN - STV <br /> ENPERM�MSERV��gH <br /> Post-it"FaxNote7671 Die 3 I f Pay„E <br /> To vtFrom O.`K! <br /> CoiDoPI, Go I <br /> Phorv!4 Pewna N <br /> Fax a / Far a <br /> Please make Checks PAYABLE to: 'ENO' - Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OE6114MMP Fees For all SERVICE FEES <br /> at tha Rale of 100%of the Base Fee Penallies wlll be added at the Rate of 10% Penaltles 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 />