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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM i "isor <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017623 <br /> Loommmmmomoma <br /> Facility ID FA0010-62-3— <br /> LUMMMMMMOMMONEN <br /> Date Printed 1/26/2007 <br /> SAM LUNG LAUNDRY INC RE : SAM LUNG LAUNDRY INC <br /> 742 E MAIN ST 742 E MAIN ST <br /> STOCKTON, CA 95202-3131 STOCKTON, CA 95202-3120 <br /> OWNER : TOY, SAM <br /> Health <br /> Date Program Description Amount <br /> Invoice# IND156923--Date of Invoice: 1/25/2007 IIIIIIIIIIIIII'/VIIVIIVIIVIVIIIIIIIIIIVI/IIIIIIIIIV /III/III <br /> 1/25/2007 2220 SM HW GEN <5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 255.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invocel $ 485.00 <br /> Payment Due Date ;212612 07 <br /> TOTAL DUE thi85s Billing��rjpENT .00 <br /> FEB 2 6 2007 <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 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 /> 524 rpt <br />