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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTIIQ�T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 (f � <br /> Phone: (209)468-3420 �1 P <br /> INVOICE Account ID AR0004199 <br /> Facility ID FA0004516 <br /> Date Printed 8/19/2009 <br /> FORWARD INC RE : FORWARD DISPOSAL SITE <br /> FORWARD DISPOSAL SITE AUSTIN RD <br /> 1145 W CHARTER WAY MANTECA, CA 95336 <br /> STOCKTON, CA 95206 <br /> OWNER : FORWARD, INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0192695---Date of Invoice: 8/19/2009 11111 11111 11111 11111 11111 11111 1111 111111 11111 IN 1111 <br /> 6/1/2009 4401 TIPPING FEES @.5 PER TON $ 41,340.00 <br /> Total for this Invoice $ 41,340.00 <br /> Payment Due Date 9/18/2009 <br /> TOTAL DUE this Billing Period 41,340.00 <br /> PAYMENT <br /> RECEIVED <br /> SEP 12009 <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 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 46 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />