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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART, NT _ Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0018159 <br /> Facility ID FA0011159 J <br /> Date Printed 3/7/2006 <br /> SRI/SURGICAL EXPRESS RE : SRI/SURGICAL EXPRESS <br /> <br /> STOCKTON, CA 95206 <br /> OWNER : SRI/SURGICAL EXPRESS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143163---Date of Invoice: 1/27/2006 1111111 111111 E 11111 11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 111 1111 IN <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/27/2006 2233 HAZARDOUS WASTE CESQT FACILITY $ 112.00 <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 Invoicel $ 636.00 <br /> Payment Due Date 3/1/20f0 t <br /> TOTAL DUE this Billing Period $ 636.00 <br /> PAS <br /> SAiV <br /> NEgLTII PTMEN'r <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 /> 5254.rpt <br />