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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTME,. Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE AccountiD AR0016929 <br /> Facility ID FA0009929 <br /> Date Printed 7/1912013 <br /> GREG J"RAUSSER RE : RAUSSER BROS TRUCKING INC <br /> RAUSSER BROS TRUCKING INC 12000 E LIBERTY"RD <br /> 12000 E LIBERTY RD GALT, CA 95632 <br /> GALT, CA 95632 <br /> OWNER : RAUSSER BROS TRUCKING INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0236094---Date of Invoice: 2/1/2013 IIIIIIII111111IIIl1111111!!IIIIIIIII1111111111111111111111111111111lIIlilllllNllIIIIIIIII <br /> 2/1/2013 1921 HMBP-Regular-Primary Location $ 300.00 <br /> 2/1/2013 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00' <br /> 2/1/2013 2832 AST FAC 10 K-<1=100 K GAL CUMULATIVE $ 675.00 <br /> 411"512013 9987 Haz Mat Program Penalty Fee $ 30.00 <br /> 4/15/2013 9994 PERMIT FEE PENALTY $ 213.00 <br /> 4/15/2013 9994 PERMIT FEE PENALTY $ 675.00 <br /> 5/3/2013 9999 PAYMENT ($ 548.00) <br /> 5/15/2013 9992 CORRECTION TO A PENALTY ($ 213.00) <br /> 5/15/2013 9992 CORRECTION TO A PENALTY ($ 30.00) <br /> Total for thislnvoice $ 1,350.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 1,350.00 <br /> • I <br /> Please rhake Checks PAYABLE to: 'EHD' Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For HMBP 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 />