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r^QUIN COUNTY <br /> �,,.r:ONMENTAL HEALTH DEPARTMwNT *a-1*a-100IPage 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0025416 <br /> Faohty lD FA0014890 j <br /> Date Printed 1/3012-012 <br /> KINGDON AIRPORT LLC RE : KINGDON AIRPORT LLC <br /> 9120 THORNTON RD 12145 N DEVRIES RD <br /> STOCKOTN, CA 95209 LODI, CA 95242 <br /> OWNER : AMRIT GREWAL <br /> Date Health <br /> t Program Description Amount <br /> Invoice# IN0224767--Date of Invoice: 1/30/2012 IIIIIIIIIIIIII III VIII IUIIIIIIIIIIIIIIIIINRIIIIIINNIIIRIhIINNNIINi IIIIIIII <br /> 1/27/2012 2244 2012 HAZMAT FEE S 255.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/2712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> Total for this Invoice $ 304.00 <br /> Payment Due Date 212912012 <br /> TOTAL DUE this Billing Period $ 304.00 <br /> O <br /> D <br /> FNvi FC 18 ?012 <br /> PER <br /> fRM oT S AV�F STH <br /> s <br /> Pe, Pt1uvg r-arVeL,Sr-tio -t 12-/1?, -wlz: <br /> �I e mS e LIrd.& , Ou,4, IaL15 t\,t�yb- wt0.1 1"�q a dolr ¢SS o <br /> .2339 W , He y t�ev Lo-),ie, Slalte G +t-a58 <br /> S-'oc1-tm1 I CA 9520C1 <br /> 71-1 aa.11c- 4 0 CA, , <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 /> ]53 qx <br />