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. ... v.. . Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTIV 'T <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0025645 <br /> Facility ID FA0015009 <br /> Date Pnnted 2/28/2011 <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: 1/31/2011 IIIIIIIIIIIIII IIIIIIIIIIIII VIII VIIIVIII VIIIIIIIIIIIII VIII IIIIIIIII VIIIIIIIIIII <br /> 1/28/2011 2220 SM HW GEN <5 TONSNR $ 213.00 <br /> 1/20/2011 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 forthis Invo(cel $ 547.00 <br /> Payment Due Date 3/212011 <br /> yA.Wft Moak.tt,�r� NOTICE TOTAL DUE this Billing Period E 547.00 <br /> 0 <br /> D <br /> MAR 112011 <br /> ENS INONM)3ER�ICELg V1 <br /> --- 1 <br /> 04y, corba4/ N0 out of DNJ)Nex3 'Pi" <br /> plea] C/o,e Cur p((ou. r 01 yv.✓ W—Co✓d <br /> P)f4fe See exclue 4 Je(ft f lie de A,- S <br /> y'k, CO"Ie,arrtpat(YrL rtal1 1, Ify(e5 <br /> Hrt sAi Pie -IP - 21D9 <br /> Please make Checks PAYABLE to: 'EHD' – Return a Copy of This STATEMENT with Your PAYMENT I ev 21 6 <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 atter the Invoice Date and each 30 Days thereafter <br /> cite..,. <br />