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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF"T Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0016948 <br /> Facility ID F FA0009948 <br /> Date Printed r 2/5/2004 <br /> JOHN ROSSI HAY CO RE : JOHN ROSSI HAY CO <br /> P.O. BOX 332 511 N AIRPORT WAY <br /> MANTECA, CA 95336 MANTECA, CA 95336 <br /> OWNER : JOHN ROSSI <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0115848—Date of Invoice: 214/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 285.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for thislnvoice $ 509.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 509.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 12 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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/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 /> >_rT+t <br />