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JHIY 4umwuum �UuIY 1 r Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME"'T <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AmountlD AR001Fi508 <br /> Facility ID FA0009508 <br /> Date Printed 4/28/2010 <br /> BONNIE L BERNEISER RE : GUARANTEE REPAIR SERVICE <br /> GUARANTEE REPAIR SERVICE 101 COMMERCE ST <br /> PO BOX 246 LODI, CA 95240 <br /> VICTOR, CA 95253-0246 <br /> OWNER : BONNIE BERNEISER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0197811 --Date of Invoice: 2/2/2010 I(IIIIII IIIIII III VIII VIII VIII(IIII VIII(IIII VIII(IIII VIII III'IIIIII VIII IIII IIII <br /> 2/1/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 300.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 30.00 <br /> 4/15/2010 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 805.00 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 805.00 <br /> L It : <br /> Delinquent ^rt�;ryep <br /> will be to <br /> in 30 dc?1/c, <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 />