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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTIVI • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOGKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account D AR0005624 <br /> LEMEMEEMMMMMMO <br /> Facility ID FA000517 <br /> LUNNOWNEMMMMA <br /> Date Printed 2/5/2004 <br /> LMMMEMEMEMEMWAM <br /> THE WINE GROUP LLC - FRANZIA RE : FRANZIA WINERY' <br /> 17000 E HWY 120 17000 E HWY 120 <br /> RIPON, CA 95366 RIPON, CA 95366 <br /> OWNER : FRANZIA WINERY LLC <br /> Health <br /> LProgram Desu'ip5on Amount <br /> Invoice# IN0115612--Date of Invoice: 2/4/2004 <br /> 2/4/2004 2214 CaIARP FAC STATE SURCHARGE FEE S 270.00 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR 5 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE S 660.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE S 24.00 <br /> Total for this Invoice $ 1,154.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period1,154.0 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 5 2004 <br /> SAN JOAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH 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 />