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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCK <br /> <br /> 003291 <br /> Facility ID FA0003712 <br /> Date Printed 2/5/2002 <br /> PERMIT DESK RE: CHEVRON STATION#94275* <br /> CHEVRON PRODUCTS USA 2905 W BENJAMIN HOLT DR <br /> PO BOX 6004 BLDG V-1140 STOCKTON CA 95207 <br /> SAN RAMON CA 94583 <br /> OWNER: CHEVRON PRODUCTS USA <br /> Health <br /> Date Program Description Firs Employee Amount <br /> Invoice# IN0090698---Date of Invoice: 1/22/2002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> 1/22/2002 2360 Underqround Storaqe Tank EH Operatinq Permit Fee Tank#006 $125.00 <br /> 1/22/2002 2360 Underqround Storaqe Tank EH Operatinq Permit Fee Tank#007 $125.00 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> 1/22/2002 2362 Underground Storage Tank EH Operating Permit Fee Tank#005 $500.00 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> 1/22/2002 2360 Underqround Storaqe Tank EH Operatinq Permit Fee Tank#008 $125.00 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> 1/22/2002 2360 Underground Storage Tank EH Operating Permit Fee Tank#009 $125.00 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> 1/22/2002 2220 SM HW GEN<5 TONSNF $200.00 <br /> Total for this Invoice $1,267.50 <br /> Payment Due Date 712002 <br /> TOTAL DUE this Billing Period $1,267.50 <br /> Please make Checks PAYABLE to: MID / Return a Copy of This STATEMENT with Your PAYMENT <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 /> 5255.rpt <br />