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SAN JOAQUIN COUNTY <br /> ENVIRUIMMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> LI LY�� <br /> INVOICE <br /> APR 2 02015 Amount ID AR 00410 33 <br /> ENVIRGNMENT HEALTH Facility ID FA 00 22450 <br /> PERMIT/SERVICES <br /> Date Printed 3/31/2015 <br /> HERNANDEZ, SUNNY RE : JOHNS MANVILLE <br /> JOHNS MANVILLE 25176 S SCHULTE RD <br /> <br /> <br /> OWNER : JOHNS MANVILLE <br /> IFDateHealth <br /> pr.gran. bescrintion Amount <br /> Invoice# IN0263405---Date ofInvoice: 1/29/2015 IIIIIIIIIIIIIVIIVIIIVIIIVIIVIIIVIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/29/2015 1921 HMBP-Regular-Primary Location $ 645.00 <br /> 1/29/2015 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> 3/15/2015 9987 Haz Mat Program Penalty Fee $ 64.50 <br /> Total for this Invoice $ 957.50 <br /> PAQ � Payment Due Date 2/2 812 01 5 <br /> DUE' TOTAL DUE this Billing Period $ 9 .50 <br /> WE WOULD APPAECIATE YOUR <br /> PAYIviENT TODAY! <br /> o\ � <br /> dv 4 <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 HMBP 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 />