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SAN.J.,�AQUIN COUNTY <br /> ENVIRGNMENTAL HEALTH DEPARTMF' " Page 1 <br /> 3Cf4 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0003208 <br /> Facility ID FA0003630 <br /> Date Printed 2/5/2004 <br /> RAI zm <br /> 9 4RE : ARCO STATION #595*mmw— <br /> BP WEST COAST PRODUCTS LLC 6100 N HWY 99 <br /> PO BOX 6038 STOCKTON, CA 95212 <br /> ARTESIA, CA 90702-6038 <br /> OWNER : BP WEST COAST PRODUCTS LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0116281 ---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 270.00 <br /> 2/4/2004 2301 UST STATE SURCHARGE $ 15.00 <br /> 2/4/2004 2301 UST STATE SURCHARGE $ 15.00 <br /> 2/4/2004 2301 UST STATE SURCHARGE $ 15.00 <br /> 2/4/2004 2360 ADDITIONAL UST $ 125.00 <br /> 2/4/2004 2360 ADDITIONAL UST $ 125.00 <br /> 2/4/2004 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 1,289.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ ms1,289.00 <br /> k ; <br /> I, <br /> Mai C'0-0 P\N� <br /> ao� - <br /> sPN�P�'v <br /> NVWO <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 OES/HMMP 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 /> >255.rpt <br />