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rayc i <br /> SAN JOAQUIN COUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTME"` RECEIVED <br /> 606 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 APR 2 0 2009 <br /> Account ID AR0020291 <br /> INVOICE SAN JOAQUIN COUNTY <br /> OFFICE OF EMERGENCY SERVICC �Dqj Facility ID FA0012434 <br /> lDate Printed3/25/2009 <br /> SPRAY-ON BEDLINERS OF STOCKTON RE : SPRAY ON BEDLINERS OF STOCKTON <br /> 15687 <br /> , CA 95210 <br /> OWNER : CLIFTON, MARY <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0185598—Date of Invoice: 1/29/2009 Illllllllllililllllllllllllllllllilllllllllllllllililllli11111IIH1111111111111111111 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 270.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> $ 27.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee <br /> Total for this Invoice $ 321.00 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 321.00 <br /> DUE <br /> Delinquent charges <br /> will he forwarded to <br /> COLLECTIONS <br /> An 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 OES 1 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 />