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SAN JUAUUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM-7 <br /> ;04—E-WEBER AVE -3RD FLOOR <br /> YOM, CA 99201 COPY <br /> 19n91468-3420AR0016869 <br /> INVOICE <br /> Account ID <br /> Fadlity ID FA0009869 <br /> Date Printed 1/3012006 <br /> HENRIQUES, EDry11AGONER, BRIAN RE : JM EQUIPMENT CO INC1245 W CHARTER WAY <br /> JM EQUIPMENT CO INC STOCKTON, CA 95206 <br /> 1245 W CHARTER WAY <br /> STOCKTON, CA 95206 OWNER : HENRIQUES, ED/WAGONER, BRIAN <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0142864—Date of invoice: 1/2712006 IIIIIIIIIIIIIIIIIIIIIII�III11111 all111111 110111111111111111111111IN111lllll <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 375.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 599.00 <br /> Payment Due Date 31112006 <br /> TOTAL DUE this Billing Rei $ 99.0 <br /> HJOAQU ZOon <br /> �l,7ROn/M `"Df/N1y <br /> OEpAR ENT <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 />