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JMIV"`W 4WUHN ti UIY I I Paye 1 ENVIRONMENTAL HEALTH DEPARTMV 600 E MAIN STREET STOCKTON, CA 95202 Phone: (209) 468-3420 INVOICE °I 5 5 W Account ID AR0016279 Facility ID F FA0011279 LM Date Printed F 4/28/2010 CUSTOM METAL FINISHING RE : CUSTOM METAL FINISHING 1550 SHAW RD #C 1550 SHAW RD C STOCKTON, CA 95215 STOCKTON, CA 95215 OWNER : CUSTOM METAL FINISHING Date Health Program Description Amount Invoice# ING196869--Date of Invoice: 12/23/2009 III II I I II II VII VI I I II II i V I VI I VIII I I IIII IIII VIII IIII IIII Hrs Employee 11/10/2009 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.50 CACAPIT $ 57.50 3/15/2010 9988 SERVICE CHARGE PENALTY $ 5.75 4/15/2010 9988 SERVICE CHARGE PENALTY $ 5.75 Total for this Invoice $ 69.00 PAST DUE Invoice# IN0198197---Date of Invoice: 2/2/2010 I illllllllllll 111 llllilllll lllll lllll lllll lllli lllll lllll1111111111111111111111111111 2/1/2010 2220 SM HW GEN<5 TONS/YR $ 213.00 2/1/2010 2244 2010 HAZMAT FEE $ 360.00 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 3/20/2010 9987 Haz Mat Program Penalty Fee $ 36.00 4/15/2010 9994 PERMIT FEE PENALTY $ 213.00 Total for this Invoice $ 871.00 Payment Due Date 314/2010 114 = L` TOTAL DUE this Billing Period $ 940.00 Delinquent chergeS will be iertivara' s d t0 C0LLEC7:1C�, '"`iS- in 30 days. Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT Penalties will be added to all Permit Fees For DES I HMMP Fees For all SERVICE FEES 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% 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter 5254.rpt