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SAN JOAQUIN COUNTY • Page 1 <br /> ENVIRONMENTAL HEALTH DEPART 'E <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0003298 <br /> Facility ID F-TFA00037119 <br /> Date Printed 1/30/2006 <br /> <br /> <br /> STOCKTON, CA 95210 <br /> OWNER : SAINI, SURINDER SINGH <br /> Dale Health Amount <br /> Program Description <br /> Invoice# IN0142898---Date of Invoice: 1/27/2006 IIIIIIIIIIII VIIVIIVIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIVIII(III IIIIIIVIII IIIIIII <br /> 1/27/2006 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 285.00 <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 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,304.00 <br /> Payment Due Date 3/112OW` <br /> ij <br /> TOTAL DUE this Billing Period $ 1,304.00 <br /> PAYMENT <br /> RECEI VED <br /> FEB 1 7 <br /> SAN JOAQUIN <br /> ENVCOUNTY <br /> HEALTH DIRONMENTAL <br /> EPARTMENT <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 DES I 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 />