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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0038799 <br /> INVOICE <br /> Facility ID FA0021434 <br /> Date Printed 9/27/2019 <br /> C/O COMPLIANCE DEPARTMENT RE : THE HOME DEPOT STORE#6660 <br /> ARCADIS U.S., INC. 2960 REYNOLDS RANCH PKWY <br /> 160 CHAPEL ROAD, SUITE 201 LODI, CA 95240 <br /> MANCHESTER, CT 06042 <br /> OWNER : THE HOME DEPOT U.S.A., INC. <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0329521 ---Date of Invoice: 9/26/2019 1111111 EIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII 11111 1111 111111 11111 1111 IN <br /> 9/26/2019 1921 HMBP-Regular-Primary Location $ 398.00 <br /> 9/26/2019 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2019 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 726.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 726.00 <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 HMBP 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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />