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SAN JQAQUIN COUNTY <br /> ENVI' ONMENTAL HEALTH DEPARTMF Page 1 <br /> 304E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468.3420 <br /> INVOICE Account ID AR0017154 <br /> Facility ID F FA00 0-154 <br /> Date Pnnted 2/5/2004 <br /> GOLDEN STATE IRRIGATION SVCS RE : GOLDEN STATE IRRIGATION SVCS <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : VALMONT INDUSTRIES <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115922--Date of Invoice: 2/412004 <br /> 2/4/2004 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 315.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 389.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 389.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 9 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> 7 <br /> &O <br /> RECEIVES F27D 1 -r' 2i;;2�,'Vk') �(�IOtiI <br /> P <br /> e,--7 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/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 />