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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF RECEIVE® <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 APR 2 0 2009 <br /> Phone: (209)468-3420 <br /> SAN JOAQUIN COUNTY AR 0032996 <br /> INVOICEFFICEOFEMERGENCY SERVICES r{ p Account ID LMEOMMMOMMMME <br /> Facility ID F FA0018631 <br /> Date Printed 3/25/2009 <br /> CLEMENTS ROAD WINERY RE : CLEMENTS ROAD WINERY <br /> 7415 ST HELENA HWY 11989 N CLEMENTS RD <br /> YOUNTVILLE, CA 94599 LINDEN, CA 95236 <br /> OWNER : JEFF LEBARD <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN01 87039—Date of Invoice: 1/29/2009 I1111111111111IIIVIIIVIIIVIIIVIIIVIIIVIIIVIIIVIIIVIIIIIII111111VIIIINIIIA <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 285.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> Total for this Invoice $ 337.50 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 337.50 <br /> PAST <br /> Delinquent Chargee <br /> will be forwarded to <br /> COLLECTION <br /> in 30 days <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 DES/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 /> 5254.rpt <br />