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SAN, JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMi f <br />.500 E MAIN STREET <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />HARDEEP SINGH <br />SUBWAY SANDWICHES <br />25440 SCHULTE RD <br />TRACY, CA 95304 <br />Page 1 <br />COPY <br />Account ID AR0036755 <br />Facility IDFA000020551 <br />Date Printed 4/28/2011 <br />RE: SUBWAY SANDWICHES <br />25440 SCHULTE RD <br />TRACY, CA 95304 <br />OWNER: SINGH, HARDEEP <br />Date Health <br />Program Description Amount <br />Invoice # IN0214078 --- Date of Invoice : 1/31/2011 <br />1/28/2011 <br />2244 <br />2011 HAZMAT FEE PLUS 1 YEAR BACK BILLING <br />$ <br />510.00 <br />1/28/2011 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />$ <br />24.00 <br />1/28/2011 <br />ERSC <br />ELECTRONIC REPORTING SURCHARGE <br />$ <br />25.00 <br />3/20/2011 <br />9987 <br />Haz Mal Program Penalty Fee <br />$ <br />51.00 <br />Total for this Invoice $ <br />610.00 <br />Payment Due Date <br />3/2/2011 <br />610.00 <br />TOTAL DUE this Billing Period <br />$ <br />,' IPAPGS �' <br />Delinquent chargee <br />will be forwarded to <br />in 30 daVs. <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 />