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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 COPY <br /> INVOIC Account to AR0038215 <br /> Facility ID FA0021180 <br /> Date Printed F 113012014 <br /> TIM JO ON RE: KOMATSU FORKLIFT USA <br /> DIES DIRECT 3727 METRO DR STE F <br /> 74 PLE ST STOCKTON, CA 95215 <br /> S UGHTON,MA 02072 <br /> OWNER: DIESEL DIRECT INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0250332--Data of Invoice; 1130/2014 I'l'I II III VIII III I IIIII II V II II11 ill 1I111I I 1111111111111111111 <br /> 1/30/2014 1921 HMBP-Regular-Primary Location $ 345.00 <br /> 1/30/2014 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1130/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Totalforthia Invoice 1 $ 593.00 <br /> Payment Due Date 31112014 <br /> TOTAL DUE this Billing Period $ 593.00 <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 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 Data 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />