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SAN JO/�QUIN COUNTY <br /> EN IIRONMENTAL HEALTH DEPARTM— 'T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 9520 <br /> <br /> AR0017909 <br /> Facility ID FA0010909 <br /> Date Printed 2/27/2006 <br /> CRAIG VEVODA RE : HUMBOLT CREAMERY ASSN <br /> HUMBOLT CREAMERY ASSN 1270 SHAW RD <br /> 572 HWY 1 STOCKTON, CA 95215 <br /> FORTUNA, CA 95540 <br /> OWNER : HUMBOLT CREAMERY INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0144005--Date of Invoice: 1/27/2006 IIIIIIIIIII VIVIIIVIIVIIIVIIVIIIVIIVIIVI IIIIIII VIIIIIIIIIII <br /> 1127/2006 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 270.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 344.00 <br /> Payment Due Date 3/1/21106 <br /> TOTAL DUE this Billing Period $ 344.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 7 2006 <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 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 />