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,VIRONMENTAL HEALTH DEPARTM6 Page 1 <br /> JO E MAIN STREET 1 . <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 COPY <br /> INVOICE Account ID AR0016814 <br /> Facility ID FA0009814 <br /> Date Printed 3/31/2010 <br /> ACTI RE : ACTI <br /> PO BOX 830 935 E SCOTTS AVE <br /> STOCKTON, CA 95201 STOCKTON, CA 95205 <br /> OWNER : ACTI <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0198697--Date of Invoice: 2/2/2010 I1111111111111IIIlIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IN 11111111111 <br /> IIII IIII <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 /> Total for this Invoice $ 379.00 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 379.00 <br /> Delinquent charges <br /> will be forwarded to <br /> COLLEC,TRON <br /> in 30. dans. <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 /> 254.rpt <br />