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3; N JOX U1N COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />304 EWE -BER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />Phone: - (209) 468-3420 <br />INVOICE <br />DONNA MURPHY <br />JR SIMPLOT CO <br />PO BOX 198 <br />LATHROP, CA 9533DV 98 <br />• <br />Page 1 <br />p,ccouM ID <br />AR0000188 <br />Facility ID <br />FA0000187 <br />Date Printed <br />F7215004 <br />RE: JR SIMPLOT CO <br />16777 HOWLAND RD <br />LATHROP, CA 95330 <br />OWNER: JR SIMPLOT CO <br />Oate��^Prolara__ mbeso�Uon - -- -- <br />Amount <br />Invoice # iN0115414 — Date of Invoice : 21412D04 <br />21412004 <br />2214 <br />C& ARP FAC STATE SURCHARGE FEE <br />?1412004 <br />2228 <br />GEN 25<50 TONS PERMIT <br />214/2004 <br />2244 <br />2404 HAZMAT FEE <br />21412004 <br />2399 <br />UNIFIED PROGRAM FAC STATE SERVICE FEE <br />S <br />270.00 <br />$ <br />1,792.00 <br />S <br />690.00 <br />$ <br />24.00 <br />Total for this Invoire $ <br />2,776.00 <br />Payment Due Date <br />TOTAL DUE this Billing Period $ 2,776.01) <br />PAYMENT <br />RECEIVED <br />MAR 1: ` 2004 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />Please make Checks PAYABLE to: 'EHD' – Rotuma Copy of This STATEMENT with Your PAYMENT <br />Penaltles will be added to all Permit Fees For OES I HMMP Fees For all SERVICE FEES <br />at the Rate of 100% of the Ease Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rale of 109. <br />30 Days after the Due Hate 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days th <br />3255.rpt <br />