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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 /> INVOICE AccounlID I AR0016802 <br /> Facility ID FA0009802 <br /> Date Printed r 5/29/2013 <br /> INJECTION MOLDING CORPORATION RE : INJECTION MOLDING CORPORATION <br /> 10824 OLSON DR STE C 922 INDUSTRIAL WAY STE K <br /> RANCHO CORDOVA, CA 95670-5651 LODI, CA 95240 <br /> OWNER : INJECTION MOLDING CORPORATION <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0236036---Date of Invoice: 2/1/2013 1 IIIIIE 1111111111111111111111111111111111111111IldIIIII IN 111111111111111 IN <br /> 2/1/2013 1920 HMBP-Common Materials S 100.00 <br /> 2/1/2013 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> 4/15/2013 9987 Haz Mat Program Penalty Fee $ 10.00 <br /> 4/15/2013 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 571.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 571.00 <br /> YOUR HEALTH PEkWu i <br /> THE CURRENT YEAR <br /> WILL NOT BE ISSUED UNI c <br /> PAST DUE t IvRC' <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />