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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTI" "T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> <br /> ountlD AR0004782 <br /> Facility ID FA0002683 <br /> Date Printed 1/2 /2005 <br /> LADD'S STOCKTON MARINA INC RE : LADD'S STOCKTON MARINA <br /> 4911 W BUCKLEY COVE WAY 4911 BUCKLEY COVE WAY <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 <br /> OWNER : BONNIFIELD, PATRICIA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0129442---Date of Invoice : 1/24/2005 11111 11111 11111 11111 IIE 11111 11111 11111 11111 1111 111111 11111 1111 1111 <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 360.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $- 584.00 <br /> Payment Due Date 2/ <br /> PAYMENT 5 <br /> RECEIVED TOTAL DUE this Billing Period $ 584.00 <br /> MAR 1 0 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 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 /> 52�5.rpt <br />