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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART 4T Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 9 <br /> <br /> AccountlD AR0017988 <br /> Facility ID FA00 i 0988 <br /> Date Printed 1/24/2005 <br /> STAN MORRI FORD RE : STAN MORRI FORD <br /> 3500 AUTO PLAZA WAY 3500 AUTO PLAZA WAY <br /> TRACY, CA 95304 TRACY, CA 95304 <br /> OWNER : STAN MORRI <br /> Date Health <br /> Program Description I Amount <br /> Invoice# ING128419--Date of invoice : 112412005 11111111IlllllIII11I111111111111111111111111111illlllilllII1IliliiII1Ill11lll11IIIIII <br /> 1/24/2005 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 315.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total forth is Invoice $ 539.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 539.00 <br /> PAYMENT <br /> RECEIVED <br /> FES 2 2005 <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 CES/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 /> _5>rpt <br />