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JAN JUAUUIN UL)UN I T <br /> ENVIRONMENTAL HEALTH DEPARTMr — Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 COPY <br /> INVOICE Account ID AR0028812 <br /> Facility ID FA0016372 <br /> Date Printed 1/26/2007Y <br /> MICHAEL D SCOTT RE : STOCKTON INDUSTRIAL SUPPLY <br /> STOCKTON INDUSTRIAL SUPPLY 336 S AURORA ST <br /> 536 S AURORA ST STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : SCOTT, MICHAEL D <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0158513---Date of Invoice: 1/25/2007 I1III1IIIIIII III VIII VIII VIII1I1I1I11I1 VIII VIII VIII VIII 11111111111 <br /> IIII IIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 115.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 345.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 345A0 <br /> PAYrnE�E© <br /> C 1 <br /> MAR `� 2 207 <br /> SAN JOA UIMENT L <br /> NEAL N 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 /> 5254.rpt <br />