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SA91 JOACtiJIN COUNTY RECEIVED Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMIO <br /> 600 E MAIN STREET APR 2 0 2009 <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 SAN JOAQUIN COUNTY <br /> INVOICE <br /> OFFICE OF EMERGENCY SERVICES Account ID AR0017843 <br /> Facility ID FA0010843 <br /> Date Printed 3/25/2009 <br /> LANE MASTERS INC RE : LANE MASTERS INC <br /> 1448 SHAW RD <br /> 1448 SHAW RD <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER: LANE MASTERS INC <br /> Health Amount <br /> Date Program Description <br /> Invoice# IN0185276--Date of Invoice : 1129/2009 IIIIIIIIIIIIIIIIIIIIAIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIIIIII <br /> $ 615.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 24.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 61.50 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee <br /> Total for this Invoice $ 700.50 <br /> Payment Due Date 2/2812009 <br /> TOTAL DUE this Billing Period $ 700.50 <br /> rr, L-JU <br /> DE IfN',QIJ0'nit charge- <br /> , J forwarded to <br /> in K(1 daVS, <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees For OES/HMMP Fees Penalties will be added at the Rate of 10 <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10 60 Das after the Invoice Date and each 30 Days thereafter <br /> 30 Days after the Due Date 45 Days after the Invoice Date Y <br /> S�Sd mt <br />