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.. .... - -- ...... <br /> SAN JOAQUIN COUNTY • Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET COPY <br /> STOCKTON, CA 95202 � <br /> INVOICE AccountiD AR0016588 �1 <br /> Facility ID FA0009588�, <br /> Date Printed 4/30/2012 <br /> ...r�J <br /> D.A. ARCHER EXCAVATING RE: DA ARCHER EXCAVATING <br /> 5948 E WATERLOO RD 775 W SECOND ST <br /> STOCKTON, CA 95215 STOCKTON, CA 95206 <br /> OWNER : ARCHER, DAVID R <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0223102---Date of Invoice: 1130/2012 111111111llll <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 345.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 112712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/1512012 9987 Haz Mat Program Penalty Fee $ 34.50 <br /> Total for this Invoice <br /> -$-428 50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 428.50 <br /> PAST DUE <br /> [delinquent charges <br /> will be fortivarded to <br /> Mr,_ in 30 days. <br /> Please make Checks PAYABLE to: 'EHO' — Return a Copy of This STATEMENT with Your PAYMENT <br /> rnalties 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 />