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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMff Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0016801 <br /> Facility ID FA0009801 <br /> Date Printed 1/28/2008 <br /> DEAN BURNSIDE RE : WOODLAKE CLEANERS <br /> WOODLAKE CLEANERS 2401 W TURNER RD 220 <br /> 2401 W TURNER RD#220 LODI, CA 95242 <br /> LODI, CA 95242 <br /> OWNER : BURNSIDE, DEAN <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0170322---Date of Invoice: 1/25/2008 IIIIIIIIIIIIIIIIIIIIIIIIVIIIVIIIVIIVIIIVIIIVIIIVIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/25/2008 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 255.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Totalforthis Invoice $ 492.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 492.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 19 2008 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONHEALTH DEPARTMENT <br /> ENT <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 CES/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 />