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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTOI`�, CA 95202 <br /> Phor ,,: (209) 468-3420 <br /> AMENDED <br /> INVOICE Account ID �AR0016060 <br /> Facility ID FA0009060 <br /> Date Printed 3/5/2004 <br /> GLEN CAMPER RE : EARTH SHELTER <br /> EARTH SHELTER 412 S SACRAMENTO ST <br /> <br /> <br /> OWNER : CAMPER, GLEN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115498---Date of Invoice : 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/5/2004 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 3/15/2004 9997 CORRECTION TO A CHARGE ($ 200.00) <br /> Total for this Invoice $ 74.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 74.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 10 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 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 /> 5255.rpt <br />