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SAN JUAQUIN L;UUN I Y Page 1 <br /> ENVIRONMENTAL HEALTH DEP 'RTMF-- <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0007834 <br /> Facility ID FA0006388 <br /> Date Printed 1/26/2007 <br /> PATEL, MAHESH RE : KWIK SERVE <br /> KWIK SERVE 950 W 11TH ST <br /> 950 W 11TH ST TRACY, CA 95376 <br /> TRACY, CA 95376 <br /> OWNER : PATEL, MAHESH <br /> Date Health <br /> Program Descriptio Amount <br /> Invoice/# IN0157906---Date of Invoice: /25/2007 I IIIIII 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 HAZ AT FEE $ 100.00 <br /> 1/25/2007 2301 UST STA SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STAT SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STAT SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITION L 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 $ 1,125.00 <br /> Payment Due Date 2/25/200 <br /> TOTAL DUE this Billing Period $ 1,125.0 <br /> 0EI��E�; <br /> FEB 22(li�l <br /> SAN JO ,QUIN COUNTY <br /> ENVIRVNME14TAL <br /> HEALTH DEP.41ITMENT <br /> Please make Checks PA ABLE 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 />