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J/iIV JUAWUIN t,UUN 1 T Pegg 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017843 <br /> Facility ID FA00-10-8 4 <br /> Date Printed3/31/2010 r <br /> nR <br /> LANE MASTERS INC RE : LANE MASTERS INC <br /> 1448 SHAW RD 1448 SHAW RD <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : LANE MASTERS INC <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0198923--Date of Invoice: 212/2010 IIIIIIIIIIII VIVIIIVIIIVIII VIVIIIVIIVIIIVIIIIIIIIIIIIIIIIIIIIII <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 615.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE .$ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 61.50 <br /> Total for this Invoice $ 725.50 <br /> Payment Due Date 31412010 <br /> TOTAL DUE this Billing Period $ 725.50 <br /> E-' 't4sT FuuE <br /> Deli quell CEl iR 0= <br /> will '(30 forviarded tO <br /> COLD .,. <br /> ir, qo days, <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to ail 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 />