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JAN JUAWIJIN I.UUN I T <br /> ENVIRONMENTAL HEALTH DEPARTMEPaye t <br /> � <br /> 600 E MAIN STREET <br /> STOCKPhone: ON,209 CA 95202 COPY <br /> Phone: (209)468-3420 �i <br /> INVOICE Account ID AR0020232 <br /> Facility ID F FA001237 <br /> Date Printed F 3/31/2010 <br /> WEST VALLEY MALL RE : WEST VALLEY MALL <br /> 3200 N NAGLEE RD STE 515 3200 NAGLEE RD <br /> TRACY, CA 95304 TRACY, CA 95304 <br /> OWNER : GENERAL GROWTH PROPERTIES <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0199078--Date of Invoice: 212/2010 I II III IIIIII I I II II II I VIII I II II II VII I I VII VI I IIII I I II VIII II I IIII <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 85.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Total for this Invoice $ 142.50 <br /> Payment Due Date 3/412010 <br /> TOTAL DUE this Billing Period $ 142.50 <br /> � J U <br /> DOlil`gi—lent C:i"Iearges <br /> coli,--LF `e CIMS <br /> ;- <br /> in ;10- 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 OES I 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 />