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0-tct@/2012 13:59 2094643 ENVIRONMENTAL H& PAGE 01/05 <br /> ENn R N UINMEN AL H I T -ter- �-k,-] r,r N)G Pae I <br /> ENVIRONMENTAL HEALTH DEPARTMENT � 9 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)4683420 <br /> INVOICE Account ID ARDD36335 <br /> Facllity 10 FA0020348 <br /> Date Printed 2!10/2012 <br /> HOME DEPOT#5641 �� RE : HOME DEPOT#5641 <br /> 1965-ASTON-AVE �/�\ 1400 PESCADERO AVE <br /> 1' TRACY,CA 95304 <br /> Vr V1V\`Zµ .a.) OWNER : HOME DEPOT USA INC,THE <br /> tet/\S 22 kh <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0226361 —Date of Invoice: 113012012 111111111111 Hill 1111111111111111 INI 111111 oil111111111111111I111111V11111IN <br /> 1/27/2012 2220 SM HW GEN<5 TONSIYR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 285.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/2712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE 9 25.00 <br /> Total for this Invoice $ 547.00 <br /> Payment Due Date 212912012 <br /> TDTAL DUE this Billing Period $ 547.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 7 201Z <br /> SAN JOAQUIN COUNTY <br /> ENVIROMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penaitles will be added to all Permit Fees For OES I 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 attire 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 />