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SAN JOAQUACOUNTY <br />ENVIRAME N fAL HEALTH DEPARTM <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />MICHELLE STEFFLER <br />METRO -PCS SAC010 <br />1755 CREEKSIDE OAKS DR., SUITE 190 <br />SACRAMENTO, CA 95833 <br />Page 1 <br />Account ID <br />AR0036340 <br />Facility ID <br />FA0020353 <br />Date Printed <br />3/31/2015 <br />RE: METRO -PCS SAC010 <br />50 TURNER RD <br />LODI, CA 95242 <br />OWNER: T -MOBILE WEST CORPORATION <br />Date Health <br />Program Description Amount <br />Invoice # IN0263168 --- Date of Invoice : 1/2912015 <br />1/29/2015 1921 HMBP-Regular-Primary Location <br />1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />3/15/2015 9987 Haz Mat Program Penalty Fee <br />1PA-AST DUE! <br />WE WOULD APPRECIATE YOUR <br />PAY ENT TODAYI <br />IIIIIIIIIIIIII III VIII VIII VIII VIII VIII VIII VIII VIII <br />VIIIIIII <br />$ <br />IIIIII VIII IIII IIII <br />300.00 <br />$ <br />35.00 <br />$ <br />30.00 <br />Total for this Invoice <br />$ <br />365.00 <br />Payment Due Date <br />2/2812015 <br />$ <br />6 .00 <br />TOTAL DUE this Billing Period <br />mm_ km <br />APR 0 2015 <br />0Z ENVIRONMENT HEALTH <br />�`�� , �� `� ,� �I � PERMIT/SERVICES <br />�� � ►2 -�1 fig' <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 HMBP 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 />