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SAN JOAQUIN COUNTY ..r Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMMMMMMMMrNT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0035535 <br /> FacilitylD I FA0019956 <br /> Date Pnnted 1/30/2012 <br /> SILVESTRE'S CONST MECH CO RE : SILVESTRES CONST MECH CO <br /> PO BOX 2507 6030 E KETTLEMAN LN <br /> LODI, CA 95241 LODI, CA 95240 <br /> OWNER : SILVESTRE HERNANDEZ <br /> Dale Health <br /> Program Description Amount <br /> Invoice# ING226244—Date of Invoice: 1/3012012 I II I I I III VIII VIII IIIIII IVI III IIII IVIIIVIII I I IIIIIIIIIIII IIII <br /> 1/27/2012 2214 CaIARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <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 /> Total for this Invoice $ 679.00 <br /> Payment Due Date 212 912 01 2 <br /> TOTAL DUE this Billing Period $ 679.00 <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 />