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loe <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES Report 15252 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 364 E WEBER AVE — 3RD FLOOR <br /> STOCKTON, CA 95202 289-468-3420 <br /> Y <br /> Billing <br /> Account Date <br /> TO : CHEVRON USA <br /> PO BOX 5004 0008424 12/15/9' <br /> SAN RAMON , CA 9458$ <br /> ATTN -. KATHY NORRIS/PERMIT DESK Facility ID <br /> RE : CHE139VROS ,CENTIONR 9OSTOC� T -085437 <br /> ON — _ <br /> PLEASE RETURN INVOICE NOTICE WITH PAYMENT <br /> Health <br /> Date Program Description u — Amount <br /> Invoice # : 044306 <br /> 12/12/97 2360 Underground Tank Permit Fee r $170 . 00 <br /> 12/12/97 2360 Underground Tank Permit, Fee NO� JwVI $170 . 00 <br /> 12/12/97 2360 Underground Tank Permit Feeli /�N�� $170 . 00 <br /> 12/12/97 2360 Underground Tank Permit Fee Q $170 . 00 <br /> 12/12/97 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $18 . 50 <br /> Total for this invoice : $698.50 <br /> L — Total Due: j618. 50 <br /> Payment DUE DATE: 01/12 /98 <br /> This INVOICE is for the ANNUAL <br /> Environmental Health PERMIT FEES e A <br /> for this FACILITY <br /> [January 1 , 1998 to December 31 , 1998] PAYMENT <br /> If this ACCOUNT has <br /> a complete monthly ACCOUNT eSTATEMENT will be RECCEVELD <br /> sent after December 20th JAN 121998 <br /> Penalties will be added on all Permits PUBLIC HEALTH SERVICES <br /> at the rate of 1008 of the Base Fee 30 ENVIRONMENTAL HEALTH DIVISION <br /> days after the due date . <br /> Please make Checks PAYABLE to: PHS/END <br /> j✓ I <br />