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s Page 1 <br /> SAN JOAOUIN COUNTY PUBLICOALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209-468-3420 <br /> INVOICE Account iD AR0003298 <br /> FA0003719 <br /> Facility ID <br /> Date Printed <br /> 1/31101 <br /> RE : CHEVRON STATION#200764* <br /> PERMIT DESK 4747 WEST LN <br /> CHEVRON PRODUCTS USA STOCKTON CA 95210 <br /> <br /> OWNER: CHEVRON PRODUCTS USA <br /> EHealth Hrs Employee Amount <br /> Dai= Program Description <br /> Invoice# IN0079425-Date of invoice : 1/30101 <br /> $100.00 <br /> 1130/2001 2220 SM HW GEN<5 TONS/YR $8.00 <br /> 1/30/2001 2301 UST STATE SURCHARGE $8.00 <br /> 1/30/2001 2301 UST STATE SURCHARGE Tank#002 $125.00 <br /> 1/3012001 2360 Underground Storage Tank EH Operating Permit Fee lank#003 $125.00 <br /> 1/30/2001 2360 Underground Storage Tank EH Operating Permit Fee Tank#001 $500.00 <br /> 1130/2001 2362 Underground Storage Tank EH Operating Permit Fee $10.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEETotalfor this Invoice <br /> Payment Due Date 3 00 <br /> TOTAL DUE this Billing Period $876.00 <br /> Please make Checks PAYABLE to: PHS/BHD / Return a Copy of This STA For III SERVI <br /> MECE FEESNT with Your PAYMENT <br /> Penalties will be added to all Permit Fees Penalties will be added at the Rate of 10°/ <br /> at the Rate of 100%of the Base Fee 60 Days after the Invoice Date and each 30 thereafter <br /> 30 Days after the Due Date <br /> PAYMENT <br /> RECEIVED <br /> MARI 421"09 <br /> pUBLIIN COUNTY <br /> CC HEOAILTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpt <br />