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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> INVOICE AccountlD AR00 882 99 <br /> LMMMMMMMEMA <br /> Facility ID FA0011279 <br /> Date Printed 4/30/2012 <br /> LENUMMOMEMMENNA <br /> CUSTOM METAL FINISHING RE: CUSTOM METAL FINISHING <br /> 1550 SHAW RD#C 1550 SHAW RD C <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : CUSTOM METAL FINISHING <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0223693...Date of Invoice: 1/30/2012 11111TO11111111111111111111IN11111111111pII IN <br /> 1/27/2012 2227 GEN 5<25 TONS PERMIT $ 1,672.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 36.00 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 1,672.00 <br /> Totalforthis Invoice $ 3,789.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 3,789.00 <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 DES/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.mt <br />