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JMI• awmWullm t Wuly I r <br /> ENVIRONMENTAL HEALTH DEPARTFAcNT Page 1 <br /> 304E WEBER AVE -3RD FLOOR <br /> STOCKPhone: ON,209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0017154 <br /> Facility ID F FA0010154 <br /> Date Printed 1/30/2006 <br /> GOLDEN STATE IRRIGATION SVCS RE : GOLDEN STATE IRRIGATION SVCS <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : VALMONT INDUSTRIES <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142946--Date of Invoice: 1/2712006 1IIII1I1II11I1III VIII VIII VIIII1I1I1I1I1I1I1I111II11II1 VIII IIII 11111111111 IN IIII <br /> 1/27/2006 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 315.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 389.00 <br /> Payment Due Date 3/ 6 <br /> TOTAL DUE this Billing Period $ 389.0 <br /> RECE uD <br /> FEB 1 u <br /> S� fPL <br /> �IRONME TMENT <br /> HE 14 DEPAP <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 />