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5AN,JUAWUIN tAUUN I Y Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME# • <br /> 000 E MAIN STREET <br /> STOCKTON, CA 95202 COPYPhone: (209) 468-3420 <br /> INVOICE 31 Account lD AROOO5451 <br /> Facility ID FA0005008 <br /> Date Printed 3/31/2010 <br /> PCI PAINTING RE : PCI-PAINTING <br /> 620 SAN JUAN AVE 620 N SAN JUAN <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 <br /> OWNER : PCI-PAINTING <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0200649---Date of Invoice : 2!212010 III[Illlllilll 111 lllllllllllllil illi!11111 lllIIIIIII 11111 Illll llllil[Illlllll 1111 1111 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 255.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 21112010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 25.50 <br /> Total for this invoice $ 329.50 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 329.50 <br /> c ` E <br /> Delinquent c'harcles <br /> vvill be j0rv\, riled t0 <br /> CC)L o WIN <br /> ip 3® da, <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!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 wilt be added at the Rate of 10% <br /> 30 Days atter the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />