Laserfiche WebLink
OM1\ JVMwui" 1. UNI 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF—`- Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STO 95202 COPY <br /> Phone:e: (209(209) 46 46 8-3420 <br /> INVOICE Amount ID IF AR0004482 <br /> Facility ID FA0002064 <br /> Date Printed 1/26/2007 <br /> IMMEMOMENOWNSMA <br /> GASOLINE ACCOUNTING RE : 7 ELEVEN STORE#14117 D/2237* <br /> 7-ELEVEN 2725 COUNTRY CLUB BLVD <br /> <br /> <br /> OWNER : 7- ELEVEN INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0157240--Date of Invoice: 1/25/2007 IIIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIIIIIIIIIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 270.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACILITY&1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for[his Invoice $ 1,155.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ ,155.0 <br /> PAYMENT <br /> RECEIVED <br /> MAR 0 2 2007 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 DES!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 /> 5254.rpt <br />