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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF <br /> 304 E WEBER!-.VE - 3RD FLOOR �.► �'� <br /> STOCK i t?N, CA 95202 <br /> Phone: (209) 468-3420 CORRECTED <br /> INVOICE Account ID AR0003663 <br /> FacilitylD FA0004027 <br /> Date Printed 3/16/2004 <br /> HENDRIX FORKLIFT SERVICE INC RE : HENDRIX FORKLIFT INC <br /> P.O. BOX 5217 103 N EST <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : HENDRIX, RICHARD <br /> Date Health - <br /> Program Description Amount <br /> Invoice# IN0115481 —Date of Invoice: 2/4/2004 <br /> 2/4/2004 2221 USED OIL ONLY-<5 TONS/VR $ 50.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 85.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/15/2004 9997 CORRECTION TO A CHARGE ($ 85.00) <br /> Total for this invoice $ 74.00 <br /> Payment Due Date 3/612004 <br /> TOTAL DUE this Billing Period $ 74.00 <br /> PAYMEN <br /> RECEIVE <br /> MAR 292' <br /> SAN JOAQUIN COON <br /> ENVIRONMENT,'. <br /> HEALTH DEPARTME_iNT <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 I HMMP Fees For all SERVICE FEES <br /> at the Rale 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 /> 5255.rpt <br />