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SAN JOAQUIN COUNTY • Page 1 <br /> ENVIRONMENTAL HEALTH DEPART <br /> MT <br /> 600 E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> [INIVOQ E AccountlD AR0033228 <br /> Facility ID FA0018 112 <br /> Date Pdnted4/30'201 j <br /> LINDA JACKSON,A/P RE: GRO-WELL BRANDS <br /> GRO-WELL BRANDS 4343 S MCKINLEY AVE <br /> PO BOX 25406 STOCKTON, CA 95206 <br /> TEMPE,AZ 85285 <br /> OWNER: GRO-WELL BRANDS <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0224810---Date of invoice: 113012012 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIN <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 345.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 112712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 311512012 9987 Haz Mat Program Penalty Fee $ 34.50 <br /> Total for this Invoice $ 426.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period. $ 428.50 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> in 30 days. <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees For DES/HMMP Fees penalties will be added at the Rate of 10 <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 45 Days after the Invoice Data 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />