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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRPNMENTAL HEALTH DEPARTMF"IT <br /> -600 E MAIN STREET <br /> STO 95202 COPY <br /> Phone:e: (209(209) 46 468-3420 <br /> 1 Account ID �AR0035514 <br /> INVOICE 1 A <br /> Facility ID FA0019935 <br /> Date Printed 3/31/2010 <br /> GREEN HORIZON RE : GREEN HORIZON <br /> 540 FILLMORE ST 611 GILMORE AVE STE <br /> SAN FRANCISCO, CA 94117 STOCKTON, CA 95201 <br /> OWNER : GREEN HORIZON <br /> Dale Health <br /> Program Description Amount <br /> Invoice# IN0200924--Date of Invoice: 2/212010 I VIII II III VIII VIII VIII VIII ill VIII VIII VIII IIT IIII VIII VIII IIII IIII <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 270.00 <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 $ 27.00 <br /> Total for this Invoice $ 346.00 <br /> Payment Due Date 3/412010 <br /> TOTAL DUE this Billing Period $ 346.00 <br /> Delinquent charge <br /> Will be forwarded to <br /> COLLEOT10,o S <br /> ir^ !.30 td0vs. <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%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 46 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />