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SAN JOAQUIN COUNTY <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF <br /> 600 E MAIN STREET <br /> STOCKTON, CA <br /> <br /> ountlD AR0003380 <br /> Facility ID <br /> FA0003795 <br /> Date Printed 1/28/2008 <br /> T 'T <br /> LIBERTY RURAL FIRE DISTRICT RE : LIBERTY RURAL FIRE DISTRICT <br /> 24124 N BRUELLA RD 24124 N BRUELLA RD <br /> ACAMPO, CA 95220 ACAMPO, CA 95220 <br /> OWNER : LIBERTY RURAL FIRE DISTRICT <br /> Date Health <br /> Proqram Description Amount <br /> Invoice# IN0170218---Date of Invoice: 1/25/2008 11111111111 E 11111 11E 11111 11111 11111 11111 11111 11111 11111�111 111111 1111�IN 1111 <br /> 1/25/2008 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 237.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 237.00 <br /> PAYIV E N l <br /> RECEIVED <br /> FEB 2 7 2001 <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 /> i254.rpt <br />