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SAN JOAOUIN COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID I AR0003 i <br /> FA0002324 <br /> Facility ID <br /> Date Printed 1/31/01 <br /> RE : PACIFIC AVE SHELL <br /> PACIFIC AVE SHELL 6131 PACIFIC AVE <br /> 6131 PACIFIC AVE STOCKTON CA 95207 <br /> STOCKTON CA 95207 OWNER : EQUILON LLC ENTERPRISES <br /> Health <br /> Ca,6 Pr:.ymm Dosoription Hr- F..mpl;r oP Amount <br /> Invoice# IN0079355---Date of Invoice: 1/30/01 <br /> 1/30/2001 2301 UST STATE SURCHARGE $8.00 <br /> 1/30/2001 2301 UST STATE SURCHARGE $8.00 <br /> 1/30/2001 2301 UST STATE SURCHARGE $8.00 <br /> 1/30/2001 2360 Underground Storage Tank EH Operating Permit Fee Tank#005 $125.00 <br /> 1/30/2001 2360 Underground Storage Tank EH Operating Permit Fee Tank#006 $125.00 <br /> 1/30/2001 2362 Underground Storage Tank EH Operating Permit Fee Tank#004 $500.00 <br /> 1/30/2001 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoicel $784.00 <br /> Payment Due Date <br /> TOTAL DUE this Billing Periodl $784;00, <br /> 11 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT---L= <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PA"(M E NT <br /> RECEIVED <br /> FEB 13 2001 <br /> SAN IO-.C; �OUh1TY <br /> PUP,t; Es <br /> 5255.rpt <br />