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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEO Page 1 <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 RECEOED <br /> Phone: (209)468-3420 AUG - 1 2006 <br /> INVOICE bANJUAUUIN ;UUNIY AccountlD AR00-11-6 3-9 <br /> OFFICE OF EMERGENCY SERVICES <br /> Facility ID FA0007486 <br /> Date Printed 8/1/2006 <br /> loomanomommommm <br /> <br /> <br /> STOCKTON, CA 95206 <br /> % <br /> OWNER : R14N4UO-MARK <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143108---Date of Invoice: 1/2712006 IIIIIIiIIIVIIIVIIIIIIIIIIIIVIIVIIVI VIII III IIIIIIIIIIIIIII IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 330.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2362 UST FACILITY B 1 TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/15/2006 9997 CORRECTION TO A CHARGE ($ 330.00) <br /> Total for thls lnvolce $ 879.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 879.00 <br /> PAYMENT <br /> RECEIVED <br /> AUG J 1 2006 <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />