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ENVIRONMENTAL HEALTH DEPARTMENT rage I <br /> 600 G MAIN STREET . • <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Q y� �� Amount ID AR0018279 <br /> Facility ID FA0011279 <br /> Date Printed 5/27/2009 <br /> CUSTOM METAL FINISHING RE : CUSTOM METAL FINISHING <br /> 1550 SHAW RD#C 1550 SHAW RD C <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : CUSTOM METAL FINISHING <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0184531 ---Date ofInvoice: 1/29/2009 111111111111111111111111 IN <br /> 1/29/2009 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 360.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 36.00 <br /> 4/15/2009 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 846.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 846.00 <br /> �011i`703uen'i c�"i � <br /> P <br /> 'mu <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 /> 5254.rpt <br />