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I— 2014 -Mar -17 1034 AM Crown Bolt 94�6 434130 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E FIAZELTON AVENUE <br />STOCKTON, CA 88206 <br />Phono: (206) 460-3420 <br />p(e� Ud <br />-Rh junai -4 116)t <br />Z41" Aldo ICO <br />HD SUPPLY DISTRIBUTION SERVICE <br />k1 a V t%E ) 601 W CHURCH 81' <br />ORLANDO, PL 22366 <br />Cik gL&r6 <br />. 2/2 <br />Pago 1 <br />V,Iqg395' <br />AuovnuD 031613�� <br />1 I ". <br />�AR0l...cilL'^.—.'W�n>1 <br />FedlllylD I FAtloie143 I1 <br />In /JLIJ(/V rflO <br />Data L. 2128,2014 <br />I J <br />RE: HD SUPPLY DISTRIBUTION SERV CBO <br />2056 INDUSTRIAL OR <br />STOCKTON, CA 08208 <br />OWNER: HD SUPPLY INC f CROWN BOLT <br />Dela Hoallh <br />Program Doserinllon Amount <br />IDvoloo ll IN024B000-- D. to of hivolco 113012014 <br />11I I1I1I I1I1II1IIII IIIIII VIII IIIIII III I1111II <br />II I IIII1I1111I <br />1IIII III /III <br />1/30/2014 1021 FIMBP-Ragulor-PrinioyLocolloo <br />u <br />5 <br />u a0a,C0 <br />11302014 2220 3M HW WN <6 TONSNR <br />S <br />813.00 <br />1/302014 2300 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />S <br />36,00 <br />Total for this lnvolco <br />s <br />630,00 <br />�IC11i4S1 <br />I��1}tj'jl"{�(ru�' <br />Payment Due Dole <br />31112D14 <br />tt`) <br />,ItJ U.G <br />TOTAL DUB thle BIIIInO Period <br />S <br />898.00 <br />Amount $ —� <br />-TED �D <br />BUNDE Expense Code <br />M� Smarlc�s - <br />bate An p ovFt J� <br />�APLPJ 't' <br />hum vi�nS <br />013 <br />Flow Inako Chooks PAYABLE to: 'EHD' — Roturn a Copy of Tide STATEMENT with Your PAYMENT <br />Povoilles will ho Addad to alt Ponell Foos For HMDP Foos For all 35RVICS FUSS <br />at ilia Rota of 100% of ilio BA90 Poo Ponaltlos will bo nddod At lho Rate of 10'1A Pe11e11169 WIII Da Added AI Ilio Rete of 10% <br />30 Days after 1110 1)110 Onto 46 Days nflor Ilia hivolco onto 00 boys aflor (ho hwolco Onto mid oath 30 Days thoroaflor <br />"U —1 <br />Received Time Mar.11, 2014 10:57AM No -5442 <br />