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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPART T. <br /> O E MAIN STREET <br /> S COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 n' <br /> INVOICE �`D� AccountlD LMMMOMMMMMA <br /> AR0016840 <br /> Facility ID F FA0009840 <br /> Date Printed 4/28/2011 <br /> WEST LANE MUFFLER& PERFORMANC RE : WEST LANE MUFFLER & PERFORMANCE <br /> <br /> STOCKTON, CA 95204 <br /> OWNER : TRAN, QUYEN <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0211700---Date of Invoice: 1/3112011 IIIIIIIIIIIIIIIIIVIIIIIIIIIIIVIIIVIIIVIIIIIIIIVIIIIIIIIIIIIIIIIII VIIIIIIIIII <br /> 1/28/20112244 2011 HAZMAT FEE $ 255.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> URCHARGE $ 25.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING S3/20/2011 9987 Haz Mat Program Penalty Fee $ 25.50 <br /> Total for this Invoice $ 329.50 <br /> Payment Due Date 3/212011 <br /> TOTAL DUE this Billing Period $ 329.50 <br /> PA�ST DUE <br /> Delinquent charges <br /> will be fomarded to <br /> in 30 days, <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees For OES I HMMP Fees penalties will be added at the Rate of 10 <br /> at the Rate of 100%of the Base Fee 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 />