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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART'--' � Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> AR0016635 <br /> LMMMMMMOMMM <br /> Facility ID FA000963 <br /> LEMMMMOMMMMEM <br /> Date Printed 3/3/2004 <br /> Inummommommoomm <br /> CORN PRODUCTS INTERNATIONAL INC RE : CORN PRODUCTS INTERNATIONAL INC <br /> PO BOX 6129 1021 INDUSTRIAL DR <br /> STOCKTON, CA 95206-0129 STOCKTON, CA 95206 <br /> OWNER : CORN PRODUCTS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115746---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 690.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 914.00 <br /> Payment Due Date 31612004 <br /> TOTAL DUE this Billing Period $ 914.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 3 - 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 DES/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 /> 5255.rpt <br />