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ENVIRONMENTAL HEALTH DEPARTMENT rage i <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 COPY <br /> INVOICE Account ID AR0005637 <br /> Facility ID FA0005189 <br /> Date Printed 1/30/ <br /> TANTIYAVARONG, VACHARA RE : AMBERLAND COMPOSITES LLC <br /> AMBERLAND COMPOSITES LLC 2807 S HWY 99 <br /> 2807 S HWY 99 STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : AMBERLAND COMPOSITES LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143059--Date of Invoice : 1/27/2006 1111111 11111 11111 11111 fill IIIIII Hill fill I0I <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 300.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 524.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 52 0 <br /> PAYS-01 1 <br /> �E <br /> WA <br /> �E8 0 9 2006 <br /> 3OPpV1td NTALN <br /> SN�TH DP PSMS <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 /> S2i4.rpt <br />