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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMF" Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0003288 <br /> Facility ID FA0003709 <br /> Date Printed 1!26/2007 <br /> LICENSE & PERMITS RE : VALERO #3698 <br /> VALERO#3698 Q� 153 E 11TH ST <br /> TRACY, CA 95376 <br /> (�4�5 l6 T1+1� Sra.MT t/ OWNER : ULTRAMAR INC <br /> Date Health <br /> Program Descriptio Amount <br /> Invoice# IN0157236---Date of Invoice: /25/2007 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 1/25/2007 2220 SM HW G N<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZIAAT FEE $ 85.00 <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 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACT ITY& 1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,110.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 1,110.00 <br /> RFCE FN7 <br /> FD <br /> SANFEB 4 <br /> E JOAOJI�d � <br /> HEA N 0 NAI ��r7-y <br /> ENr <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fee 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 />