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SA UIN COUNTY <br /> E ENTAL HEALTH DEPARTMEO • Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR C{�CEfVE� <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 JUN -2 200E <br /> INVOICE bANdUAUUINUUUNIY AccountlD FAR0006891 <br /> OFFICE OF EMERGENCY SERVICES <br /> Facility ID FA0005940 <br /> Date Printed 5/23/2006 <br /> CALIFORNIA SPRAY DRY CO* RE : CALIFORNIA SPRAY DRY CO* <br /> PO BOX 5035 4221 E MARIPOSA RD <br /> STOCKTON, CA 95205-0035 STOCKTON, CA 95215 <br /> OWNER : MODESTO TALLOW COMPANY <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0142632--Date of Invoice: 1/27/2006 11111111111111111111111 <br /> 1/27/2006 2214 CaIARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 615.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2006 9987 Haz Mat Program Penalty Fee $ 61.50 <br /> 4/15/2006 9994 PERMIT FEE PENALTY $ 200.00 <br /> Total for this Invoicel $ 1,370.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 1,370.50 <br /> "'`.spy,+��•w,,xmr� � ` -?�J <br /> UOn1 Gt d t0 <br /> K�sO\ir C, Ocat O <br /> 1t� 3 <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 I 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 />