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ENVIRONMENTAL HEALTH DEPARTMF Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE �' ^ RECEIVE®A�°untlD AR0035030 <br /> JUL 3 0 2009 <br /> Facility FA0019668 <br /> LUMMUMMMMEMA <br /> SAN JOAQUIN COUNTY Date Printed 7/28/2009 <br /> ]FACE OF EMERGENCY SERVICES LMONEEMENOMMEMMM <br /> JAMESJORDAN RE : JAMESJORDAN <br /> 45 W WORTH ST 45 W WORTH ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : JAMES L JORDAN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND189678---Date of Invoice: 5/26/2009 11111111111111111111 IN 1111111111111111111111111111111111 IN <br /> 5/26/2009 2244 2009 HAZMAT FEE S 270.00 <br /> 5/26/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 7/15/2009 9987 Haz Mat Program Penalty Fee $ 27.00 <br /> Total for this Invoice $ 321.00 <br /> Payment Due Date 6/2612009 <br /> TOTAL DUE this Billing Period $ 321.00 <br /> Deiinquent charges <br /> MH be fey forded to <br /> in 30 dans. <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 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 /> S?C 1 m, <br />