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SAN JGAQUIN COUNTY LIS V-W0 130 <br /> ENVIRONMENTAL HEALTH DEPARTMPeNT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID F AR0003609 <br /> FacilltylD F FA0003984 <br /> Date Printed F 1/30/2012 <br /> ENVIRONMENTAL DEPARTMENT RE : PEP BOYS#0710 <br /> PEP BOYS#0710 845 DR MARTIN LUTHER KING JR BLVD <br /> 3111 W ALLEGHENY AVE STOCKTON, CA 95206 <br /> PHILADELPHIA, PA 19132 <br /> OWNER: PEP BOYS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0223367--Date of Invoice: 1130/2012 IIIIIIIIIIIIIV IVIIIVIIIVIIVIIIIIII VIIVIIIVIIIII IIII IIIIII IIIIIIIIIIIII <br /> 1/27/2012 2228 GEN 25<50 TONS PERMIT $ 1,911.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE S 25.00 <br /> Total for this Invoice $ 2,320.00 <br /> Payment Due Date 2/29/2012 <br /> TOTAL DUE this Billing Period $ 2,320.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 7 2012 <br /> SAN JOAQUIN COUNTY <br /> ENVIROMENTAL <br /> HEALTH DEPARTMENT <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 OES I 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 />