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AfJ .10110I1.iW (,UUNTY PUBL. (C WAIL ill :.,(.k'VILI ', RepotLWbs <br /> FNW RONMENTAL HEALTH DIVON St ment Printed - 02/25/99 <br /> 304 E WEBER AVENUE -• 3RD*OOR <br /> STOCKTON . CA 95202 <br /> Ac Counting Office : 209 468-3420 <br /> i <br /> I <br /> '(0 : MAIN STREET BEACON #474 Y" -- " — <br /> 3440 E MAIN ST Account # 0009105 <br /> SfOCKFON , CA 95206 '� <br /> ATTN : SOHAIL RASAIZ & KHALIL BASAIZ Facility ID 006423 <br /> RE : MAIN STREET BEACON #474 <br /> 3440 EMAIN ST <br /> STOf.KTON <br /> 11.111E RETURN a COPY of 1111 STITENENT with 1111 11Y1E1T <br /> J Service Activity <br /> nnte nescr , ptoon Hrs Employee Amount <br /> Invoice # 054303 -- Date of Invoice: 01/28/99 <br /> 01 /28/99 2301. UST State Surcharge Fee Tank # PR507753 $24 . 00 <br /> �. 01 /28/99 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $143 . 00 <br /> 01/28/99 2360 UST Permit Fee Tank # TA504864 $170 . 00 <br /> 01/28 /99 2360 UST Permit: Fee Tank # TA504863 $.170 . 00 <br /> !al. /7rt /99 2360 UST Permit. Fee Tank N TA504862 17.70 . 00 <br /> Total for this invoice : $549 .0 <br /> 2 9 <br /> If this INVOICE has been Paid, Please Oisregard this Notice PAYMENT <br /> 31z1 y9 P4� PF-r�.F-Fvf"r' <br /> MAR - 2 1999 <br /> SAN JOAQUIN PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> For all SERVICE FEES penalties will <br /> Penalties will be added on all Permits be added at the rate of lit 60 days <br /> at the rate of 101E of the Base Fee 30 past invoice date and each 31 days <br /> days after the due date. thereafter. <br /> TOTAL DUE this Billing Period: $544 . 09 <br /> Please make Checks PAYABLE to : PIIS/EHO <br /> O` <br /> i <br />