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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMPNT Page 1 <br /> 600 E MAIN STREET r <br /> STOCKTON, CA 95202 COPY <br /> <br /> <br /> Facility ID FA0010909 <br /> V�Nf s.e ck l-15e c oo4 c� N fl ISI <br /> Date Printed 2/26/2010 <br /> �daac,y Ga.Lt.l p <br /> FOSTIik--� 'l7\1 RE : HUMBOLT CREAMERY ASSN <br /> HUMBOLT CREAMERY ASSN l�\� 1270 SHAW RD <br /> 529 KANSAS AVE STOCKTON, CA 95215 <br /> MODESTO, CA 95351 VVV`��\ <br /> OWNER : FOSTER FARMS DAIRY <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0199473—Date of Invoice: 2/212010 VIII IIII I I VII VIII VIII I IIIIIII VIII VIII III IIIIIIIIII(IIII IIIIIIIII IIII <br /> 2/1/2010 2221 USED OIL ONLY-<5 TONS/YR $ 54.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> Total forthis Invoicel $ 103.00 <br /> Payment Due Date 314/2010 <br /> TOTAL DUE this Billing Period 103.00 <br /> F � <br /> P/WMEN <br /> RECEIVED <br /> MAR 2 2 2010 <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 /> 5254.rp1 <br />