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SAN JOAQUIN COUNTY <br /> ENVIRU'NMENTAL HEALTH DEP RTM' T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA <br /> 420 <br /> INVOICE AccountlD AR0002335 <br /> Facility ID FA0002321� <br /> Date Printed 1/30/2006 <br /> UNITED GAS* RE : UNITED GAS* <br /> PO BOX 1136 440 W CHARTER WAY <br /> TRACY, CA 9537 STOCKTON, CA 95206 <br /> OWNER : GILL, JODHA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142342---Date of Invoice: 1/24/2006 11111 111 11111 11111 IN 111111 11111 1111 IN <br /> 1/24/2006 1616 RETAIL MARKET< 1000 SQ FT W/FOOD PREP- $ 160.00 <br /> Total for this Invoice $ 160.00 <br /> Payment Due Date 3/1/2006' <br /> o <br /> Invoice# IN0144192---Date of Invoice: 1/27/2006 IIIIIIIIIIIIIIIIIIII IIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIII IIIIIIIIIII IIIIIIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HA MAT FEE $ 285.00 <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 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 $ 1,164.001, <br /> Payment Due Date / 6 <br /> TOTAL DUE this Billing Period $ 1,324. <br /> FE� 2 <br /> f <br /> SAENJOAQUtf,/,CUfu <br /> T <br /> L <br /> HEq O; 1� "C- AL <br /> y DEPARrMEA/T <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fee 5 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 /> 5254.rpt <br />