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ENVIRONMENTAL HEALTH DEPARTM—NT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 I�. <br /> INVOICE ^ O Account ID AR0025645 <br /> Facility ID F FA 0015-0 0-9 <br /> Date Printed 2/15/2011 <br /> PACIFIC COAST MS INDUSTRIES RE : PACIFIC COAST MS INDUSTRIES <br /> PO BOX 1020 3940 COMMERCIAL ST <br /> LEBANON, KY 40033-5020 TRACY, CA 95376 <br /> OWNER : PACIFIC COAST MS INDUSTRIES IN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0212337---Date of Invoice: 1/3112011 I VIII II I IIIIIIIIIIII VI IVIIIVIIIVI I IIIIVI VII IIIIIII IIIIIIIIIIIII <br /> 1/28/2011 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/26/2011 2244 2011 HAZMAT FEE $ 285.00 <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 $ 547.00 <br /> Payment Due Date 3/2/2011 <br /> TOTAL DUE this Billing Period $ 547.00 <br /> o <br /> FEB 282011 <br /> ENVIRONMENT PERMI /SEFIVICES HEALTH <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 /> i2a4.rpt <br />