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05/03/2011 15:20 2094640138 ENVIRONMENTAL HEALIH ruin oirw <br /> _... _ , • Page 1 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 60o E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3"20 AMID AR0035504 <br /> INVOic� F <br /> F.Olty l0 A0019825 <br /> Dale Named 3730/2011 <br /> DERALD TORREY <br /> RE : DERALD TORREY <br /> 1020 W PARK ST <br /> 1020 W PARK ST STOCKTON,CA 95205 <br /> STOCKTON.CA 95205 <br /> OWNER: DERAL13 TORREY <br /> Amount <br /> Health <br /> Date Prom Description <br /> I�IIII��I1�11�1�IIIII�gV�II�II�N91gION <br /> Invoice I IN0213820—Date el"w"M! 1131/2011 <br /> $ 185.00 <br /> 1128!2011 2244 2011 HAZMAT FEE s 24.00 <br /> V28r2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE 3 25.00 <br /> 112812011 ERSC ELECTRONIC REPORTING SURCHARGE 3 28.50 <br /> 3120/2011 9987 Hax Mat Program Penaay Fee Tom brMAteveka S 382.50 <br /> Payment Due Date 3/212011 <br /> TOTAL DUE this Billing Period $ 362.50 <br /> Please make Checks PAYABLE to: 'EHD' — Rah rn a Copy of Thls STATEMENT with Your PAYMENT <br /> FW 411 SERVICE FEES <br /> PenaRles w01 be added m ae Pam"'Fees <br /> For DES I"MMP Fees panaftles well be added at the Rete o/10% <br /> at the Rate 01100%o1 the base Fac Panak�tnDWa YS a Imonc'Det 10% 60 Days atter the Invoice Data end each 30 Days thereafter <br /> 30 Day,'it"the Due Date <br /> 525!,fA <br />