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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE AcccuntID AR000slos <br /> Facility 10 FA0006423 <br /> Date Printed 2/2/2015 <br /> GALVAN,JULIO RE : UNITED GAS <br /> UNITED GAS 3440 E MAIN ST <br /> 3440 E MAIN ST STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : GALVAN,JULIO <br /> Date Health <br /> Program Description <br /> Amou <br /> Invoice# IN0258148—Date of invoice: 1111912014 __�lIil IIIII IIIIIIIIII IIIIIIIIIIIIIilllllllllllllll 111111111 111111 <br /> 11/19/2014 1615 RETAIL MKT 301-2000 SO FT(PREPKGD/LTD PREP) $ 03.00 <br /> r, Total for this Invoice $ 2 .00 <br /> ,,,Payment Due Date 0 <br /> Invoice# IN0260704--Date of Invoice: 1129/2015 11111111 111111 III IIIII 1111111 IIII IIIIIIIIII IIIIIIIIII IIIII IIIII IIIIIIIIIIIIIII IIII IIII <br /> 1/29/2015 1920 HMBP-Common Materials $ 85.00 <br /> 1/29/2015 2220 SM HW GEN<5 TONS/YR $ 213 <br /> 1/29/2015 2301 UST STATE SURCHARGE FEE $ 15 0'' <br /> 129/2015 2301 UST STATE SURCHARGE FEE ^ $ 1 .00/ <br /> 1292015 2301 UST STATE SURCHARGE FEE yl, $ 5.00/ <br /> 129/2015 2360 ADDITIONAL USTfV.1'°I,_) $ 30.00 <br /> 1292015 2360 ADDITIONAL UST J <br /> 129/2015 2362 UST FACILITY 8 1 TANK $ �n 550.00' <br /> 1292015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.001/ <br /> a To I for this Invoice $ 11188.00 <br /> Y ' <br /> �I �7,� Hyl /ft Due Date 2/2 812 01 5 <br /> AL DUE this Billing Period 1,391.00 <br /> + <br /> IS <br /> �d -7 s-D <br /> ��( <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Yo r PAYMENT <br /> Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />