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SAN JOAQUIN COUNTY , Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT .� <br /> COPY <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> INVOICEAccount ID AR0035506 <br /> � Cj �J <br /> Facility ID FA0019927 <br /> Date Printed 4/30/2012 <br /> WINE BOTTLE RENEW RE : WINE BOTTLE RENEW <br /> <br /> STOCKTON, CA 95205 <br /> OWNER : WINE BOTTLE RECYCLING LLC <br /> Health Amount <br /> Date Program Description <br /> Invoice# IN0226223---Date of invoice: 1/30/2012 IIIIIIIIIIIIIIIIIIIIIIIIIIIVIIVII 111111111 IN <br /> $ 285.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 24.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 25.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 28.50 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee <br /> Total for this Invoice $ 362.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 362.50 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> C®LLECTEONS <br /> in 30 days. <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 DES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 101 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 />