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04/01/2009 11:21 2094640138 ENVIRONMENTAL HEALTH PAGE 01/01 <br /> SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMEO <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 RECEIVE® AR0O22664 <br /> INVOICE Ac tID <br /> APR - 1 2009 Faesh1y11) FA0013555 <br /> SAN JOAQUIN COUNTY Date Punned 2/9/2009 <br /> OFFICE OF EMERGENCY SERVICES <br /> GUTIERREZ FABRICATION RE : GUTIERREZ FABRICATION <br /> PO BOX 1897 1500 SHAW RD <br /> SAUSALITO,CA 94966-1697 STOCKTON,CA 95215 <br /> OWNER : LOKKESMOE, BARBARA <br /> Dote Health <br /> Program Description Amount <br /> Invoices INOIRM97--Date ofInvolee: 1129f2009 IIIA�IIBAI�NNIII��IIIN�� I�I�II�IIII�IINI�� <br /> 1/29/2009 2244 2000 HAZMAT FEE 4 255.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Tatty fw this Insoke $ 279.00 <br /> Payment Due Date 212812009 <br /> TOTAL DUE this Billing Period S 279.00 <br /> 3�4 - ftse,)M, advtsecl 4W' w0 I0(1ler �wuC an <br /> }'11U. vA on, 6,,t�,4 (reg Gam- izr,a l�K"E <br /> �15�33�.-IIKS <br /> Please make Checks PAYABLE no: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permk Fees For DES/HMMP Fear For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Panahle ,will be added at the Rata of 10% Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 45 Days after the Involce Date 60 Days after the Invoice Daft and each 30 Days t%hereafte <br /> 5254 rpt <br />