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SAN JUAUUIN UUUN I Y • Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME9 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICECOPYAccount ID AR0016079 <br /> a <br /> ILFacility ID FA0009079 <br /> Date Printed 5/30/2012 <br /> ABC RADIATOR RE : ABC RADIATOR <br /> 601 S WILSON WAY 601 S WILSON WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : EDWARD F FORTUNE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0223161 ---Date ofInvoice: 1/30/2012 �1111111 EIII 111111111111111111111111111111111111111111111111111111111111111111111 <br /> 1/27/2012 2220 SM HW GEN<S TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 330.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 33.00 <br /> 4/15/2012 9994 PERMIT FEE PENALTY - $ 213.00 <br /> Total for this Invoice $ 838.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 838.00 <br /> PAST DUE <br /> Delinquent Charges <br /> will be forwarded to <br /> COLLECTIONS <br /> in 30 days. <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 I HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added.atthQ.,Rate of,113%. ,..... , enalttiiP4 will bg,acjeed atzthe.Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Tn%o ce Date and each 30 Days thereafter <br />