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SANJOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM Page 1 <br /> 600 E MAIN STREET .. <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE 11 11 Account ID AR0016845 <br /> FacilityID FA0009845 <br /> Date Printed F 2/28/2011 <br /> W <br /> DELTA <br /> <br /> , CA 95205 <br /> OWNER : HOFFMAN, CURT <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0210932--Date of Invoice: 1/31/2011 IIIIIIIIIIII VIIIIIIIIIIIII VIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/28/2011 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 285.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total for this Invoice $ 547.00 <br /> Payment Due Date 3/2/2011 <br /> TOTAL DUE this Billing Period $ 547.00 <br /> re <br /> MAR - 4 2011 <br /> E PEHMIT/ SERUICES HEALTH <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 DES/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 /> _'4 rpl <br />