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SAN JQAQUIN COUNTY . Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM* <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468.3420 <br /> INVOICE Account ID AR0005748 <br /> Facility ID FA0005287 <br /> Date Printed 2J5/2004 <br /> HERMAN & HELENS MARINA RE : HERMAN & HELENS MARINA <br /> 15135 W EIGHT MILE VENICE ISLAND FERRY 15135 W EIGHT MILE RD <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 <br /> OWNER : SMITH,ANDREW <br /> Health Amount <br /> Proyra <br /> Date r) Descriprnn <br /> Invoice# IN0116223---Date of Invoice: 2/4/2004 S 200.00 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR S 315.00 <br /> 214/2004 2244 2004 HAZMAT FEE $ 24.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE <br /> Total for this Invoice $ 539.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 539.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 12004 <br /> �N.a���lnn,axrnulall�r <br /> Thr: ,�r:nalBwtva� <br /> ►�AiLTM�RFRHOIG�pIG <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 /> 5255.rpt <br />