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;AN JOAQUIN COUNTY Page 1 <br /> _NVIRONMENTAL HEALTH DEPARTME'lltaw r <br /> i00 E MAIN STREET <br /> 1TOCKTON, CA 95202 (RECEIVED <br /> 5hone: (209)466-3420 AR0004690 <br /> INVOICE JUL 13 2011 Account In <br /> FAOD02456 <br /> SAN JOAQUIN COUNTY facility ID <br /> OFFICE OF EMERGENCY SERVICES Dote Pr nlBd 711 312 0 1 1 <br /> ' \ <br /> RE : GARLIC BROTHERS <br /> GREG RISSO 6629 EMBARCADERO DR <br /> GARLIC BROTHERS STOCKTON, CA 95209 <br /> 6629 EMBARCADERO OR <br /> STOCKTON,CA 95209 <br /> OWNER : RISSO, GREG <br /> Health Amount <br /> Date Program Deserirltion – <br /> Invoiceq IND213893—Date of kwaCe: 11311"" <br /> IIl1i IINII���Ifl11 tlIN Al11�N�ill����fl�NO�IAII le0 �ry1 ryX�^ <br /> $ 255.00 <br /> v2e12o11 2244 2011 HA2MAT FEE $ 24.DO <br /> 112912011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE g 25.00 <br /> 1128/2011 ERSC ELECTRONIC REPORTING STATE SURCHARGE FFF $ 25.50 <br /> 3r20=11 9987 Haz Mat Program Penally Fee <br /> Total Wthk Invoko $ 329.50 <br /> PAST DUE <br /> TOTAL DUE this Blllirtg Period <br /> $ 329.50 <br /> Please make Checks PAYABLE to: 'EHD' – Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> PenattitM will lx added to all Pere F Fees For DES f ed at Fees Penalties wilt be added e1 the Rate of 10:4 <br /> at Me Rata of 1e0Y.o!the Base Fee Penalties will 11e added at the Rata Of 10% <br /> 30 Dart's after the Due Date 45 Days after the Invoice Daft 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254 rpt <br />