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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMr"T Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> <br /> 002102 <br /> Facility ID FA0002094®i <br /> Date Printed 1/29/2009 <br /> WIGHT, LAWRENCE RE : ARCO#2133 <br /> ARCO#2133 2908 W BENJAMIN HOLT DR <br /> 2908 W BENJAMIN HOLT DR STOCKTON, CA 95209 <br /> STOCKTON, CA 95209 <br /> OWNER : WIGHT ENTERPRISES#2 LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0183596---Date of Invoice: 1/28/2009 /�/ I IIIIIII IIIIII III VIII IIIII IIIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 1/28/2009 1615 RETAIL MKT<2000 SQ FT (PREPKJDLTQPF P) $ 175.00 <br /> Total for this Invoice $ 175.00 <br /> Payment Due Date 2/28/2009 <br /> Invoice# IN0187102---Date of Invoice: 1/29/2009 IIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIII IIIIIIIIIIIIIIIIIIII IIIII IIIIIIII <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 237.00 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 412.00 <br /> T <br /> PAY i=ivT <br /> RECEIVED <br /> .-EB 9 2009 <br /> SAN JOAQUIN COU <br /> ENVIRONMENTA NN <br /> HEALTH DEPARTMENT <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 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 /> �254.rpt <br />