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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (200) 468-3420 <br />INVOICE <br />SYNERGY HEALTH <br /> <br /> <br />Page 1 <br />Account ID <br />018159 <br />Facility ID <br />FA0011159 <br />Date Printed <br />2/28/2017••• <br />RE: SYNERGY HEALTH <br />6801 LONGE ST <br />STOCKTON, CA 95206 <br />OWNER: SYNERGY HEALTH <br />Date Health <br />Prooram Description Amount <br />Invoice # IN0288332 --- Date of Invoice : 1/26/2017 <br />1/26/2017 1921 HMBP-Regular-Primary Location <br />1/26/2017 1922 CERS Processing Fee <br />1/26/2017 2220 SM HW GEN <5 TONS/YR <br />1/26/2017 2237 HAZARDOUS WASTE CECIL FACILITY <br />1/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII <br />$ <br />IIIIII VIII IIII IIII <br />329.00 <br />$ <br />25.00 <br />$ <br />226.00 <br />$ <br />126.00 <br />$ <br />35.00 <br />Total for this Invoice $ <br />Payment Due Date <br />TOTAL DUE this Billing Period $ <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />741.00 <br />2/25/2017 <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 />5254.rpt <br />