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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTHDEPARTNIEIVT RECEIVED E MAIN STREET <br /> STOCKTON, CA 96202 <br /> Phone: (209)468-3420 MAR -6 2012 <br /> INVOICE SAN JOAQUNCOIJNTY AccountlD ARI�a1s5s6 <br /> OFFICE OF EMERGENCY SERVICE <br /> n <br /> /(/��) T Facility 10 FA0009566 <br /> �(}�'■' <br /> F & H 7/�/NS 1 RWTION Date Printed L 1130/2012 <br /> FEB 0 2. 2012 <br /> F&H CONST RE : F&H CONST <br /> PO BOX 2329 '4,F"FWED 6'T 4945 E WATERLOO RD <br /> LODI, CA 95241-2329 y FILASTOCKTON, CA 95215 <br /> OWNER : F S H CONSTRUCTION <br /> Dale Health <br /> t o.c,ram DescapSM <br /> Invoice# ING224123—Date of Invoice: 113012012 l IIIIIII Illlll IrI VIII It1lI Illi VIII 111111III�I11QII!{III VIII IN IIIA IN IN IIII <br /> 1/27/2012 2244 2012 HAZMAT FEE I 1 II III II 9!11 !!11 P {I!+1 1111 I 1 I Il 1 I <br /> $ 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 Periodl $ 379.00 <br /> �Nll <br /> 2 <br /> \ � <br /> 3hA <br /> 12 <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©ES 1 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 /> 5"5i rpt <br />