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JAN JUAUUIN t:UUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTIlfT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID ARO0 77342 <br /> Facility ID FA0010342 <br /> Date Printed F 1/28/2008 <br /> <br /> <br /> MANTECA, CA 95337 <br /> OWNER : FRANCES LEE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170494---Date of Invoice: 1/25/2008 1II11III III II II VII VIII VI V II IIID V IIII 11 11111111111111111111 IN IIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 255.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 492.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 492.00 <br /> PAY T <br /> RECEIVED <br /> FEB 2 0 2008 <br /> SAN OROV COUIV7y <br /> HEgLTH p PAR MENT <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 />