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............ ........ <br /> -------- --------------- <br /> SAN JOAQUIN COUNTY Page I <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 96202 <br /> Phone. (209)468-3420 <br /> INVOICE Account ID AR0025024:1 <br /> Facility ID FA00147'7 <br /> Date Printed 3/28/2012 <br /> EASTSIDE AUTO REPAIR RE : EASTSIDE AUTO REPAIR <br /> <br /> STOCKTON,CA 96215 <br /> OWNER: EDMUNDO AYALA <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0224737---Date of Invoice: 113012012 11111111111111111111 IN 1111 <br /> 1/2712012 2220 SM HW GEN<5 TONS/YR. $ 213.00 <br /> 1/2712012 2244 2012 HAZMAT FEE $ 85.00 <br /> 1/2712012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24,00 <br /> 1127/2012 ERSC ELECTRONIC.REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 311512012 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Total for $ 355.50 <br /> Payment Due Date 212912012 <br /> TOTAL DUE this Billing Period $ 355.50 <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 OES 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 />