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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 RECEIVED <br /> I NVO N C E �✓FEB 2 S 2012 Account ID AR0003087 <br /> SAN JOAQUIN Facirty Ip FA0003509 <br /> NTy <br /> OFFICE OFEMERGENCY E VICES Date Printed 1/3D12012 <br /> GRUTMAN,ANDREW N RE : ACME TRUCK PARTS EQUIPMENT INC <br /> ACME TRUCK PARTS EQUIPMENT INC 1049 S WILSON WAY <br /> PO BOX 449 STOCKTON, CA 95205 <br /> STOCKTON, CA 95201 <br /> OWNER : ACME TRUCK PARTS & EQUIP INC <br /> Date Hearth <br /> Program Description Amount <br /> Invoice 4 IN0223433---Date of Invoice: 1/3012012 1111111111111E 11111111111111111111111111111111111111111111111111111111111111!11IN 1111 <br /> 112'02012 2228 GEN 25<50 TONS PERMIT $ 1,911.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 345.00 <br /> 1127/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1127/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> Total for thls Involoe $ 2,305.00 <br /> Payment Due Date 212912012 <br /> TOTAL DUE this Billing Period $ 2,305.00 <br /> PA'y l <br /> SAN JDAC)�, t:C1 i,l a�• <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 1 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.j-pt <br />