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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM" <br /> 304 E WEBER AVE - 3RD FLOOR " <br /> STO <br /> <br /> ccountlD AR0003539 <br /> Facility ID FA0003934 <br /> Date Printed 8/4/2004 <br /> SHARI BRIGDON RE : LLNL-SITE 300* <br /> LLNL-SITE 300* CORRAL HOLLOW RD <br /> PO BOX 808 L-627 TRACY, CA 95376 <br /> LIVERMORE, CA 94551-0808 <br /> OWNER : UNIVERSITY OF CALIFORNIA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0123234---Date of Invoice: 8/4/2004 11111 11111 1111 111111 11111 IN 1111 <br /> 8/4/2004 2229 GEN 50<250 TONS PERMIT $ 2,016.00 <br /> 8/15/2004 9996 APPLY DISCOUNT (Paid 3/23/04—Ck#67633) ($ 200.00) <br /> Total for this Invoice $ 1,816.00 <br /> Payment Due Date 9/3/2004 <br /> TOTAL DUE this Billing Period $ 1,816.00 <br /> PAYMENT <br /> RECEIVED <br /> AUG 3 0 2004 <br /> SAENVIRONMENTALO � <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 /> 5255.rpt <br />