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rage I <br /> JMIY JVMI{VIIV l.VV1V 1 I <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET ,. 1.W COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID A00 <br /> R17807 <br /> Facility ID FA0010807 <br /> LMMMMMMMMMMA <br /> Date Printed 3/31/2010 <br /> QWEST COMMUNICATIONS CORP RE : QWEST COMMUNICATIONS CORP <br /> 1801 CALIFORNIA ST 952 E LINDSAY ST <br /> DENVER, CO 80202 STOCKTON, CA 95202 <br /> OWNER : QWEST COMMUNICATIONS CORP <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0198915---Date of Invoice : 2/2/2010 IIIIIIIIIIIII VIIIVIIIVIIVIIIIIIVIIIVIIIVIIIIIIIIIIIIIIIIIIIIIIIIII IIII <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 285.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> Total for this Invoice $ 362.50 <br /> Payment Due Date 3/412010 <br /> TOTAL DUE this Billing Period $ 362.50 <br /> { U <br /> 00irigtient Charge <br /> will b6 lorward0d tO <br /> in 30 CIONS. <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> ra will beadded to all Permit Fees For OES/HMMP Fees For all SERVICE FEESRate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10%0 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 />