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ENVIRONMENTAL HEALTH DEPARTMENT • <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPYPhone: (209)468-3420 G RECEIVED <br /> INVOICE \ Account ID AR0035752 <br /> Jn I <br /> ` 'j L`"�J�iFA0020057 <br /> Facility SD <br /> SAN JOAOUIN COUNTY <br /> OFFICE OF EMERGENCY SERVICMDate Printed 5/26/2011 <br /> REYNOSO, MARIO RE : R & S TRANSMISSION <br /> R& S TRANSMISSION 24572 S MACARTHUR <br /> <br /> <br /> OWNER : REYNOSO, MARIO <br /> Date Health <br /> Program Description Amounl <br /> Invoice# IN0213906---Date of Invoice: 1/31/2071 Illlllll1111111111111111111111111111!111111111111111111111111111111111111111111111111 <br /> 1!28!2011 2220 SM HW GEN e5 TONS/YR $ 213.00 <br /> 9/28/2011 2244 2011 HAZMAT FEE $ 85.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/20/2011 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> 4/15/2011 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this invoice $ 568.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 568.50 <br /> �ggq1���qqq'eI S 9 1 <br /> t n <br /> VA(illbo, <br /> , '' i .A'✓ti <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 OES 1 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 />