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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEP, ,RTMr T Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0006129� <br /> Facility ID FA0005534 <br /> Date Printed 4/25/2006 <br /> HARBIR S BAL RE : THE SERVICE STATION <br /> THE SERVICE STATION 1100 W 11TH ST <br /> 1100 W 11TH ST TRACY, CA 95376 <br /> TRACY, CA 95376 <br /> OWNER : BAL, HARBIR S <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143328---Date of Invoice: 127/2006 11111 11111 11111 11111 IN 111111 11111 1111�111 <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZ AT FEE $ 130.00 <br /> 1/27/2006 2399 UNIFIED P OGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2006 9987 Haz Mat Program Penalty Fee S 13.00 <br /> 4/24/2006 9999 PAYMENT (S 354.00) <br /> Total for this Invoice $ 13.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 13.00 <br /> �1r, TY N <br /> PAYMENT <br /> RECEIVED <br /> JUN 14 2006 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAN ABLE 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 /> i2i4.rpt <br />