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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM41T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0035039 <br /> Facility ID FA001 6677 <br /> Date Printed 1/30/2012 <br /> JASON'S WHOLESALE RE : JASON'S WHOLESALE <br /> 2444 STATION DR STE D 2444 STATION DR STE <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : JASON MATECKI <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0226136...Date of Invoice: 1/30/2012 111111111111111111 IN 11111111111111 IN <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 330.00 <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 /> Total for this Invoice $ 379.00 <br /> Payment Due Date 2/29/2012 <br /> TOTAL DUE this Billing Period $ 379.00 <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 rpt <br />