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rayc <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE I Account l0 _AR 0028317 <br /> Fadlity ID FA0016194 <br /> l Date Pnnted 5/27/2009 <br /> CRYSTAL VALLEY CELLARS LLC RE : CRYSTAL VALLEY CELLARS LLC <br /> PO BOX 1827 16750 E HWY 88 <br /> WOODBRIDGE, CA 95258-1827 LOCKEFORD, CA 95237 <br /> OWNER : COSENTINO SIGNATURE ENT <br /> Date Health Amount <br /> Prog-am Description <br /> Invoice# IN0185864--Date of Invoice: 1/29/2009 IIIIIIIIIIIIIVIIIIIIIIIIIIIVIIIIIIIIIIVIIIIIIIIIIIIIIIIIIII VIII IIII IIII <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 300.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 30.00 <br /> Total far this Invoice $ 354.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 354.00 <br /> DUE <br /> Deiinc, P,nt Cl ,arges <br /> ti4 V., for\njard,3d 10 <br /> in 3_q 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 OES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 100" <br /> 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 />