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OAN JUAWUIN t UUN I T <br /> ENVIRONMENTAL HEALTH DEPARTM-''T OcC'D J A NI 3 1, 2001 Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> <br /> 468-3420 COPY <br /> INVOICE AccountlD AR0003277 <br /> Facility ID FA0003699 <br /> s, <br /> �zrsu„rea�s . <br /> Date Printed 1 1/26/2007 <br /> DSS COMPANY RE : DSS COMPANY <br /> PO BOX 6099 655 W CLAY ST <br /> STOCKTON, CA 95206-0099 STOCKTON, CA 95206 <br /> OWNER : KNIFE RIVER CORP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0156416---Date of Invoice : 1/25/2007 11111 1111 111111 11111 IN�111 <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 390.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoicel $ 1,275.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ - 1,275.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 0 5 2001 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <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 /> 5254.rpt <br />