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SAN JOAQUIN COUNTY / <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Amount ID AR0030277 <br /> FacilitylD F FA0017395 <br /> Date Printed 1/3012012 <br /> DASILVA DAIRY RE : DASILVA DAIRY <br /> 16880 S HENRY RD 16551 S HENRY RD <br /> ESCALON, CA 95320 ESCALON, CA 95320 <br /> OWNER : DASILVA DAIRY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0225538--Date of Invoice: 1/30/2012 III III IIIIIII II IIII IIIV IIVIIIVII VIIIILI VIII IIIIIIIIIIIII1HIIIN <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2223 AGRICULTURAL HAZ MAT STORAGE FACILITY $ 18.00 <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 /> I Total for this Invoice $ 280.00 <br /> Payment Due Date 212912012 <br /> TOTAL DUE this Billing Period $ 280.00 <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/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 />