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oris JUAWUlly GUUNI Y <br /> ENVIRONMENTAL HEALTH DEPARTM' T Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account to AR0022667 <br /> Facility ID r FA0013558 <br /> Date Printed 1/26/2007 <br /> MWMENMMNMMNEM <br /> KEMPER <br /> <br /> CA 95240 <br /> OWNER : KEMPER REFRIGERATION <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0157098---Date of Invoice: 1/25/2007 II11II1IIIIIEIII ME11111I1IIIII111II11I11IIIE1111I1II111IIIIIIN111III11IIIfill III <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 300.00 <br /> $ 24.00 <br /> Total for this Invoice $ 530.00 <br /> Payment Due Date 2/25/ 07 <br /> TOTAL DUE this Billing Period $ 530.00 <br /> PAYMENT <br /> REMNED <br /> MAR 15 2007 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — Return <br /> a Copy of This$TATENIENT with Yourr-PAYlofENT- <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 /> 5254spt <br />