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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM� Page 1 <br /> 600 E MAIN STREET • <br /> STOCKTON, CA 95202 i <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0004177 <br /> Facility ID E FA0004495 <br /> Date Printed � 1/28/2008 <br /> RO LAB AMERICAN RUBBER CO RE : RO LAB AMERICAN RUBBER CO <br /> PO BOX 450 8830 W LINNE RD <br /> TRACY, CA 95378-0450 TRACY, CA 95304 <br /> OWNER : RO LAB AMERICAN RUBBER CO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0169995---Date of Invoice: 1/25/2008 I IIIIIII IIIIII III VIII VIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIIIII 11111 <br /> IIII IIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 390.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 627.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 627.00 <br /> �Ec�ty E� <br /> SAN JOAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> JAN 3 12008 <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 /> 5254.rpt <br />