Laserfiche WebLink
E <br /> OAN JUAI.IUIN L UUN I Y Page 1 <br /> ENVIR'ONMENTAL HEALTH DEPARTM-"T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE AccounIID AR0003410 <br /> Facility ID F FA0002048 <br /> PLEASE NAIL <br /> PERMIT 70 Date Printed F 1/30/2006 <br /> BILLING ADDRESS lommummmmmmmmmm <br /> USA GASOLINE#835 RE : USA GASOLINE#835 <br /> <br /> STOCKTON, CA 95204 <br /> OWNER : USA PETROLEUM CO <br /> Date Health <br /> Progr2m Description Amount <br /> Invoice# IN0143393--Date of Invoice: 1/27/2006 IIIIIIIIIIIIIIVIIVIIIVIIIVIIIVIIVIIVIVIIVIIIVIIIIIIIIIIIIVIII IIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 100.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,119.00 <br /> Payment Due Date 3/1!2006 <br /> TOTAL DUE this Billing Period $ 1,119.00 <br /> RSC FAV r <br /> FFB �o <br /> H� rly MFNrry <br /> Please make Checks PAYABLE to: 'Ei - 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 />