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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMr T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 9 <br /> <br /> INVOICE TE Q Account ID AR0003277 <br /> Facility ID FA0003699 <br /> Date Printed 1/30/2006 <br /> DSS COMPANY RE : DSS COMPANY <br /> PO BOX 6099 655 W CLAY ST <br /> STOCKTON, CA 9 206-0099 STOCKTON, CA 95206 <br /> OWNER : KNIFE RIVER CORP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142559---Date of Invoice : 1/27/2006 1111111 111111 E 11111 11111 11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 11111 1111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 390.00 <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 $ 1,269.00 <br /> Payment Due Date 3/ <br /> TOTAL DUE this Billing Period $ 1,269.00 <br /> PA YM E <br /> REC'EF11.;I,D F <br /> FEB s'4^/�O�QE,. ,• <br /> � �„'` ENV �• .: <br /> SAN JO EAL7-N <br /> ENVIRO V `OUN1Y UFI:If <br /> ,"EALTH D NMENTAL <br /> EP`r?TMENT <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 /> 5254.rpt <br />