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SAWJOAQ61N COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET Page 1 <br /> STOCKTON, CA 95202 j y� <br /> INVOICE }�/�\ ,L/arD 'iJ Account ID AR0003438 <br /> /(�I i' ( Facility ID r FA0003850 <br /> lommunummmmmwml <br /> Date Printed 4/30/2012 <br /> IMMOOMMOOMMEMEM <br /> M&M BUILDERS SUPPLY INC RE : M&M BUILDERS SUPPLY INC <br /> PO BOX 1107 8111 W 11TH ST <br /> TRACY, CA 95378 TRACY, CA 95304 <br /> OWNER: M&M BUILDERS SUPPLY INC <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0224126--Date of Invoice: 1/30/2012 IIIIIIIIIIIIIIIIIIIIIIIIIIIIII�II�IIIIIIIIIIIIi 1111111111111 <br /> 112712012 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 270.00 <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 /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 27.00 <br /> Total forthis Invoice $ 346.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 346.00 <br /> FAST DUDE <br /> Delinquent charges <br /> will be forwarded to <br /> COLLEC B"9ONS <br /> sit,, 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 I 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 />