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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR00141 99 <br /> LMEMOMMUMMMOM <br /> Facility ID FA0007815 <br /> Dale Printed 1/26/2007 <br /> <br /> <br /> MANTECA, CA 95336 <br /> OWNER : ESCOBAR, FRANCENE M <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0157252—Date of Invoice: 1/25/2007 IIIIIIIIIIIIIIIII VIII VIIIVIIIIIIIIIIIIIIIIII VIIIIIIIIVIII VIII IIII IIID 111111111111 <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 300.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,325.00 <br /> Payment Due Date7 <br /> TOTAL DUE this Billing Period $ 1,325.0 <br /> D <br /> FEB 12 zoos <br /> COUNTY <br /> ENWR <br /> SALT DDN� MeVr <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 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 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 />