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SAN JOAQUIN COUNTY _ <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE Account lD AR0032443 <br /> Fatality ID r FA0018396 <br /> Date Printed F 3/27/2014 <br /> WEYERHAEUSER RE : WEYERHAEUSER <br /> 2700 S CALIFORNIA ST 1111 HUMPHREYS AVE <br /> STOCKTON, CA 95206 STOCKTON, CA 95203 <br /> OWNER : WEYERHAEUSER <br /> Dale Health <br /> Program Description <br /> Amoc- <br /> Invoice 0 IN0249951 --Date of invoice: 1/30/2014 11111111111111 11h IIIIIIN1111111111111111111111111111111111111111IF1111 <br /> 1/30/2014 1920 HMBP-Common Materials $ 115.00 <br /> 1/30/2014 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for MIs invoice $ 363.00 <br /> Payment Due Date 3/1/2014 <br /> V31 - ; , ti;') R TOTAL DUE this Billing Period $ 363.00 <br /> ti <br /> moped aUli4� �asf �t�cr (3 , 2b13 <br /> our s OUMI S- ('All,prn'1 to <br /> C4 - s;pD <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 HMBP 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 /> 254 rpt <br />