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SAN JOAQUIN COUNTY �1 <br /> ENVIRONMENTAL HEALTH DEPART T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0028828 <br /> LEEMMMMOMMUM <br /> Facility ID FA 0016384 <br /> 7 1 <br /> Date Printed 1/31/2011 <br /> BUTLER, BEN E RE : GUINETTIS BODY SHOP <br /> GUINETTIS BODY SHOP 1624 E ALPINE AVE 1678 <br /> <br /> <br /> OWNER : BUTLER, BEN E <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND212501 ---Date of Invoice: 1/31/2011 III�IIIIIIIIIIIIIIIIVII VIIVII VI VI VIIIVIIVIII II IIII IIIIIIIIIIII <br /> 1/28/2011 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total for this Invoice $ 262.00 <br /> Payment Due Date 3/2/2011 <br /> TOTAL DUE this Billing Period $ 262.00 <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 10o%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 />