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JANJUAWUIN GUUNIY <br /> ENVIRONMENTAL HEALTH DEPARTMF-'T Page 1 <br /> 600E MAIN STREET - RECEIVE® COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AUG Jr 2011 Account ID AR0034317 <br /> —11 <br /> OFFlCEQFEAQUIN CCU <br /> MERgENCV ' Facility ID FA0019303 <br /> SERVICES <br /> Date Printed 2/28/2011 <br /> ROOF RANGERS RE : ROOF RANGERS <br /> PO BOX 5114 129 HOOPER DR <br /> GALT, CA 95632 STOCKTON, CA 95203 <br /> OWNER : PATRICK W MAPLE <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0213674—Date of Invoice: 1/3112011 IIIIIIIIIIIIIIIIVII VIIVIIIVIIIIIIIIIIIIIIIIIIIIIIIIIII IIII IIIIII VIII IIII IIII <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 285.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total for this Invoice $ 334.00 <br /> Payment Due Date 31212011 <br /> TOTAL DUE this Billing Period $ 334.00 <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 I 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 />