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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMPage 1 <br /> F0 <br /> 304 IF hIEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017456 <br /> Lumommommmmmma <br /> Facility ID F FA0010456 <br /> Lmommommmmmmme <br /> Date Pnnted 2/5/2004 <br /> SIERRA CHEMICAL CO (STKN) RE : SIERRA CHEMICAL CO (STKN) <br /> 1010 INDUSTRIAL DR 1010 INDUSTRIAL DR <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : STANLEY K KINDER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0116457---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2214 CaIARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 2/4/2004 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 690.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 1,184.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $, 1,184.00 , <br /> PAYMENT <br /> RECEIVED <br /> MAR 18 2014 <br /> SAN JOAQUIN COUNT y <br /> ENVIRONMENTAL <br /> F{FALTH DEPARTMENT <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 OES/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 />