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Page 1 <br /> SAN JOAQUIN COUNTY • <br /> ENVIRONMENTAL HEALTH DEPARTMT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 gR0018012 <br /> INVOICE AccountlD <br /> Facility ID FA0011012 <br /> Date Printed 1/29/2009 <br /> PACIFIC COAST INDUSTRIES <br /> RE : PACIFIC COAST INDUSTRIES <br /> 4101 N HOLLY DR <br /> PO BOX 1081 TRACY, CA 95376 <br /> TRACY, CA 95378 <br /> OWNER : PACIFIC COAST MS INDUSTRIES IN <br /> Amount <br /> Health <br /> Date program Description <br /> Invoice# IN0184511 ---Date of Invoice: 112912009 IIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIII IIIIIIIIII VIII VIIII$IIIIIII111111III13. 0 <br /> 1/2912009 2220 SM HW GEN<5 TONS/YR $ 360.00$ 24.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE Total for this Invoice <br /> Payment Due Date 2128/2009 <br /> TOTAL DUE this Billing Period <br /> LRN yup Q1,�i�Sr C1��N�'1F o�n- Mh��IrJI� AO�P'F3S <br /> PAYMENT <br /> 1-0 '. RECEIVED <br /> �� 1hL Com IN9�5 i�I�S FEB 2 3 2009 <br /> -1, I o 1 Hour SAN JOAQUIN COUNTY <br /> Tky I <br /> C , 1;VT(0j ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> 3\� i <br /> Please make Checks PAYABLE to: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT <br /> For OES/HMMP Fees For all SERVICE FEES <br /> =te <br /> to all Permit Fees Penalties will be added at the Rate of 10°/ <br /> f the Base Fee Penalty will be Days aftetthe Inved at the Rate oice Date f 10% 60 Days after the Invoice Date and each 30 Days thereafter <br /> Due Date <br /> 5254 rpt <br />