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u�i air<ua♦ <�.<u <u�v uYu<�o u�v<nura u�rra rz,�rn , ...� .... u< <br /> ..... - -- • • Pagel <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 AR003550a <br /> INVOICE A='nlb <br /> Fxn4lu FA0019925 <br /> Dale Printed 3130001 i <br /> DERALD TORREY <br /> RE : DERALD TORREY <br /> 1020 W PARK ST <br /> 1D20 W PARK ST STOCKTON,CA 95205 <br /> STOCKTON.CA 95205 <br /> OWNER: DERALD TORREY <br /> Amount <br /> Health <br /> Date prom Description <br /> I�Ifll�rvgnllliQ l3H IINN111111 mini <br /> Imoict o M(1213820--Date M lovoi"! 1!312011 $ 285.00 <br /> 112811011 2244 2011 HAWAT FEE E 24.00 <br /> 1/2812011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE 3 25.00 <br /> 1/28(2011 ERSC ELECTRONIC REPORTING SURCHARGE f 28.50 <br /> 320/7011 9987 Haz Mat Program Penally Fee r <br /> 1 TOEot brehb lnvnlea '1362.50 <br /> Payment Dire Date 312/2011 <br /> TOTAL DUE this BOling Period $ 362.50 <br /> Please make Checks PAYABLE to: 'FHIY — RetuM a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> at <br /> ti's at beadded104'4 f he Potnit Fees <br /> For DES!"MMP Fees Penalties will be added at the Rate of 10% <br /> et Lha Rote of 1009.o/the ea'a Fee Panah4esD II be added lat theRe�a of 10% Days cher the involea Data and each 70 Days thereafter <br /> 30 Day,'het the Dae Date 1's <br /> 5254.rpt <br />