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08/09/2011 14:42 2094640138 EWIRONMENTAL HEALTH PAGE 01/01 <br /> ENWRONMENTAL HEALTH DEPARTI&T Page 1 <br /> 000E MAIN STREET <br /> ' STOCKTON, CA 91202 <br /> Phone: (209)4683420 <br /> INVOICE Ax tID AR0017329 <br /> Pa„Ttr o FA0010329 <br /> Dale PAnw 7/27/2011 <br /> OAKRIDGE WAREHOUSES RE : OAKRIDGE WAREHOUSES <br /> PO BOX 1823 1004 TILDE LEWIS OR <br /> OAKOALE,CA 95361 STOCKTON,CA 95208 <br /> OWNER: O'DANIEL,TRISH <br /> Date Health_.__ _ __._.._.Droyram _._-Deseriplitm _ <br /> ____.__.. _.._.... _. ._._.._ 1�pp �( �1■gy�pp A�Iml��goul�lnNpl <br /> Invoket IN8Q11618—Ogle of khrhLe: tp1f21111 ���®�®�I�■I�R1101�IRPIW1111 <br /> 1/2812011 2244 2011 HAZMAT FEE S WOO <br /> 1282011 2399 L"FIED PROGRAM FAC STATE SURCHARGE FEE S 24.00 <br /> 112&2011 ERSC ELECTRONIC REPORTING SURCHARGE 5 25A0 <br /> 3202011 9987 Haz Mel Program Penalty Fee S 8.50 <br /> Tab!fm khb analm $ 142.50 <br /> PAST DUE <br /> .. :. - TOTAL DUE this Billing Peiod S 142.50 <br /> Plnx make Checks PAYAB31t: 1EHO' - Retum a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Pemm Fees For OE3 f HMMP Fees For an SERVICE FEES <br /> at the Rale of 109%of the Baas Fee Penalties will be added at the Raft of 101E Penatles will be added at the Rab of toy. <br /> 70 Drys Nler the om Oar K Dry"atrr em Invoke Data 60 Drys after the Invoke Mie and each 30 Drys <br /> 5254.gm <br />