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SAN JOAQUIN COUNTY t m� Page 1 ENVIRONMENT,AL,HLTH DEPARTP 304 E WEBER AVE - 3RD FLOOR STOCKTON, CA 95202 Phone: (209)468-3420 INVOICE THREE PALMS GROCERY 6732 E WATERLOO RD STOCKTON, CA 95215 Account ID AR0003669 Facility ID FA0004030 Date Printed 3/5/2003 RE: THREE PALMS GROCERY 6732 E WATERLOO STOCKTON, CA 95215 OWNER: BOZZANO, LINO I Date Health Program Description $ 0.00 Total for this Invoice Invoice # IN0104595 -- Date of Invoice : 2/27/2003 Payment Due Date 4/4/2003 2/27/2003 2244 2003 HMMP Annual Fee $ 2/27/2003 2301 UST STATE SURCHARGE SECOND $ 2/27/2003 2301 UST STATE SURCHARGE NOTICE $ 2/27/2003 2360 ADDITIONAL UST $ 2/27/2003 2362 UST FACILITY & 1 TANK $ 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ Total for this In oice $ Payment Due Date Invoice # IN0105491 --- Date of Invoice : 3/5/2003 3/5/2003 2220 SM HW GEN <5 TONS/YR 5255.rpt Amount 85.00 10.00 10.0 125 0 0 .00 17.50 i47.50 29/P003 PAYMENT RECEIVED MAR 1 7 2003 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONNIENTAt HEALTH DIVISION s Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT Penalties will be added to all Permit Fees For all SERVICE FEES at the Rate of 100% of the Base Fee Penalties will be added at the Rate of 10% 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter $ 0.00 Total for this Invoice $ 200.00 Payment Due Date 4/4/2003 TOTAL DUE this Billing Period $ ._947-50— PAYMENT RECEIVED MAR 1 7 2003 SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONNIENTAt HEALTH DIVISION s Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT Penalties will be added to all Permit Fees For all SERVICE FEES at the Rate of 100% of the Base Fee Penalties will be added at the Rate of 10% 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter