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UJ/1Jr Lull 1tl:L4 LOJYOYUl00 v�V 1Ru�Cy��nL rcwin r uUy <br /> JMMI 4VAt4u11Y HV Vr`l1 1 <br /> ENVIRONMENTAL HEALTH DEPARTMV • Page 1 <br /> 600 E MAIN STREET <br /> 'STOCKTON, CA 95202 COP <br /> Phone: (209)468-3420 1 n 0 1Y <br /> INVOICE 0.� A2 ntID AR0000479 <br /> Fadliry ID FA0000480 <br /> Date P,Inte4 4/28/2011 <br /> ROCKYS RESTAURANT RE: ROCKY$ RESTAURANT <br /> PO BOX 2601 14659 N THORNTON RD <br /> LODI, CA 95241 LODI,CA 95242 <br /> OWNER: SENIGNO,BEVERLY <br /> Date Health <br /> Program Description 11I Amount <br /> Invoice IN0212271—Date of Invoice: 1/3112011 Il l'H$IIIII II���I�I�II�� II�1111111111111 <br /> 1128/2011 2244 2011 HAZMAT FEE $ 8500 <br /> 1f2&2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/2812011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/15/2011 9997 CORRECTION TO A CHARGE ($ 8.50) <br /> 3/20/2011 9987 Haz Mat Program Penalty Feey S 8.50 <br /> 4142011 9999 PAYMENT PAST DUE (S 134.00) <br /> 425/2011 9003 RETURN CHECK FEErlelln vent charges $ 28.00 <br /> 98 <br /> 4/25/2011 99CORRECTION TO A PAYMENT'-' q 7 S 13400 <br /> will be forwarded to <br /> SO4MECTI0's,113 total for chis Invoice S 162.00 <br /> in '30 days. Payment Due Date 3/2/2011 <br /> Invoice IN0214910---Date of Invoice: 3/292011 JOIN$Ills I III oil 111l1lu11uIll N111111111111Ni1 <br /> Hts Employee <br /> 2/15/2011 1626 333-INSPECTION/REINSPECTION(1 hr minimum) 1.00 YOAKUM $ 122.00 <br /> Tabt for this 1nv0ite S 122.00 <br /> Payment Due Date 4/2812011 <br /> TOTAL DUE this Billing Periotl $ 284.00 <br /> Please make Checks PAYABLE to: 'END' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penaltles will he added to all Pamnit Fees For DES 1 HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rata of 10% Penalties wig be added at the Rate of 10 <br /> 30 Days after the Due Data 45 Days after the Involca Date 60 Days after the Invoice Data and each 30 Days theneafte <br /> 3254 rpt <br />