Laserfiche WebLink
'SAN JOAQUIN COUNTY <br /> ENVIRONME.NTAL HEALTH DEPARTST Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 / <br /> INVOICE Ar untID AR0004656 <br /> Circle K Stores Inc. <br /> Licensing Dept. DC 36 FacililytD FA0002590 <br /> <br /> Date Printed F 2/27/2003 <br /> MARCH L 7 #255886 RE : CIRCLE K#8671 <br /> <br /> STOCKTON, CA 95209 <br /> OWNER : CIRCLE K STORES INC <br /> Date Health <br /> Prouram Description Amount <br /> Invoice# IN0104647—Dale of Invoice: 212712003 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 285.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2362 UST FACILITY&1 TANK $ 500.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invocel $ 1,082.50 <br /> Payment Due Date 312912003 <br /> TOTAL DUE this Billing Period $ 1,082.50 <br /> PAYMENT <br /> RECEIVED <br /> MAR Z 1 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SRVICES <br /> ENVIRONMENTAL HEALTH DIVISION <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />