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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMO <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0000649 <br /> Facility ID FA0000650 <br /> Date Printed 5/16/2014 <br /> SINGH,JATINDER RE : SUNSHINE TRAVEL PLAZA <br /> SUNSHINE TRAVEL PLAZA 1022 E FRONTAGE RD <br /> <br /> <br /> OWNER : SINGH,JATINDER <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0247020---Date of Invoice: 1/30/2014 IIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIIVIIIVIIIVIIIVIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/30/2014 1921 HMBP-Regular-Primary Location $ 285.00 <br /> 1/30/2014 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/30/2014 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/30/2014 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/30/2014 2360 ADDITIONAL UST $ 125.00 <br /> 1/30/2014 2362 UST FACILITY&1 TANK $ 550.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> 1/30/2014 2832 AST FAC 10 K-</=100 K GAL CUMULATIVE $ 675.00 <br /> 4/15/2014 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2014 9994 PERMIT FEE PENALTY $ 675.00 <br /> 4/15/2014 9994 PERMIT FEE PENALTY $ 550.00 <br /> 4/15/2014 9994 PERMIT FEE PENALTY $ 125.00 <br /> 4/15/2014 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this lnvoicLj $ 3,504.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 3 504.50 <br /> 1 <br /> 30p, <br /> A Ift PAROwof <br /> 1v `t J Ne —IVAO <br /> ? u <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 HMBP Fees For all SERVICE FEESPenalties will be added at the Rate of 10% <br /> a In <br /> at the Rate of 100%of the Base Fee Penalties will added the Rate of 10% 60 Das after the Invoice Date and each 30 Days thereafter <br /> 30 Days after the Due Date 45 Days after the Invoice Date Y <br /> 5254.rpt <br />