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690 E MAIN STREET • • <br /> V'OCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 ry (� <br /> INVOICE (�(�� �✓EI V`dCye <br /> D Account ID AR0018211 <br /> Xy O \ ^ Facility ID FA0011211 <br /> SAN JOAQUIN COUNTY Date Printed 5/26/2011 <br /> OFFICE OF EMERGENCY SERVICES <br /> QUALITY CABINET SHOP RE : QUALITY CABINET SHOP/PORT CITY PLUM <br /> 3256 E TOMAHAWK DR 3256 TOMAHAWK DR <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : QUALITY CABINET SHOP/PORT CITY <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0212042—Date of Invoice: 1131/2011 IIIIIIIIIIIIIIIIIIIIIIIIIIIIiIIVI VIIIVIIIIIIIIIiiVIIIIIIIIIIIVIIIIIIIIII <br /> 1/28/2011 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 270.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/20/2011 9987 Haz Mat Program Penalty Fee $ 27.00 <br /> 4/15/2011 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for thls Invoice $ 772.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 772.00 <br /> R <br /> rues <br /> �elingUer'11 - 10 <br /> i e $O�`�s�P�0 <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 /> i2i4.rpt <br />