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WC <br /> AQUIN COUNTY Page 1 <br /> NMENTAL HEALTH DEPARTST <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 / <br /> Phone: (209)468-3420 J <br /> INVOICE Account to AR0004645 <br /> FacilitylD FA0002463 <br /> Date Printed 2/27/2003 <br /> GAS 4 LESS RE : FOOD 4 LESS <br /> 8014 LOWER SACRAMENTO RD#1 678 N WILSON WAY <br /> STOCKTON, CA 95210 STOCKTON, CA 95205 <br /> OWNER : PAQ INC <br /> a` <br /> Health —- — <br /> Healtm Description Amount <br /> -Progra <br /> Invoice# IN0102947—Date of Invoice: 2/19/2003 <br /> Hrs Employee <br /> 1/7/2003 1617 444-COMPLAINT INSPECTION 1.00 NGUYEN $ 89.00 <br /> Total for this Invoice <br /> Payment Due Date <br /> Invoice# IN0104200—Date of Invoice: 212712003 <br /> 2/27/2003 2220 SM HW GEN<S TONS/YR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 85.00 / <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 2362 UST FACILITY&1 TANK $ <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Involcel 947.5 <br /> Payment Due Date 912003 <br /> TOTAL DUE this Billing Period $ 1,036.50 <br /> PAYMENT <br /> RECEIVED <br /> MAR 12 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC SERVICES <br /> ENVIRONMENTALLTH HEAL H )VISION <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.mt <br />