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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPART`—T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID I AR0003362 <br /> Facility ID F FA0002111 <br /> Date Pnntetl 2/28/2006 <br /> PORTILLO, A; KENDRICK, J RE : BEN HOLT SHELL <br /> BEN HOLT SHELL 3011 W BENJAMIN HOLT DR <br /> 3011 W BENJAMIN HOLT DR STOCKTON, CA 95219 <br /> STOCKTON, CA 95219 <br /> OWNER : PORTILLO, A; KENDRICK, J <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142623--Date of Invoice: 1/27/2006 IIIIIIIIIII III IIIIIIII VIII VIII VIII VIII VIII VIII VIIIIII IIIIII VIIIIIIIIIII <br /> 1/27/2006 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 145.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this lnvolce $ 369.00 <br /> Payment Due Date 3/112006 <br /> TOTAL DUE this Billing Period $ 369.00 <br /> �ECCN NOTACE <br /> MAR (I 8 2006 <br /> SAN JOAOUIT,:; <br /> ENVIRONMOUP.'PI <br /> HEALTH DFEOtjr <br /> P�RTMENr <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 /> 5254.rpt <br />