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It <br />i <br />•w+ <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />INvoic COPY <br />VALLEY PACIFIC PETROLEUM SERVICES <br />j SZ r FRANK WEST CIR 5+e - 1010 <br />STOCKTON, CA 95206 <br />Page 1 <br />Account ID <br />AR0007490 <br />Facility ID <br />FA0006289 <br />Date Printed <br />2/1/2013 <br />RE: VALLEY PACIFIC PETROLEUM SERVICES <br />166 FRANK WEST CIR <br />STOCKTON, CA 95206 <br />OWNER: VALLEY PACIFIC PETROLEUM SERVICES <br />Date Health <br />Program Description Amount <br />Invoice # IN0235579 --- Date of Invoice : 2/1/2013 <br />2/1/2013 1921 HMBP-Regular-Primary Location <br />2/1/2013 2220 SM HW GEN <5 TONS/YR <br />2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />2/1/2013 2832 AST FAC 10 K - </=100 K GAL CUMULATIVE <br />111111111111111111111111 IN <br />$ 360.00 <br />$ 213.00 <br />$ 35.00 <br />$ 675.00 <br />Total for this Invoice $ 1,283.00 <br />Payment Due Date 3/3/2013 <br />TOTAL DUE this Billing Periodl 1,283.00 <br />PAYMENT <br />RECEIVED <br />FEB 2 7 2013 <br />SAENOAONIN COUNTY <br />NTAL <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 thereaftei <br />5254.rpt <br />