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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE AozountID AR0009105 <br /> LMMMEEMMENOMMM <br /> Facility ID FA0006423 <br /> Date Printed 2/2/2015 <br /> GALVAN, JULIO RE : UNITED GAS <br /> UNITED GAS 3440 E MAIN ST <br /> 3440 E MAIN ST STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : GALVAN, JULIO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0258148---Date of Invoice: 1111912014 1111IIIIIIII I VI IVII 11IV I VI VIIIV IVI 1111 1111111110111111 <br /> 11/19/2014 1615 RETAIL MKT 301-2000 SO FT(PREPKGD/LTD PREP) $ 03.00 <br /> 4� Total for[his Invoice $ 2 .00 <br /> ?� 1 2,Q�j Payment Due Date 0 <br /> oas5 <br /> Invoice# IN0260704---Date of Invoice: 1129/2015 1111111111111I1I111111111111VIII111111111I1I111111111111111111111IN11111111111INIIII <br /> 129/2015 1920 HMBP-Common Materials $ 85.0 <br /> 1/292015 2220 SM HW GEN<5 TONS/YR $ 213. <br /> 1/29/2015 2301 UST STATE SURCHARGE FEE — S 15 0'� <br /> 1/29/2015 2301 UST STATE SURCHARGE FEE - ^ $ 1 .00/ <br /> 1/29/2015 2301 UST STATE SURCHARGE FEE ^ $ 5.00 <br /> 129/2015 2360 ADDITIONAL UST / {v17`"J l� J $ 30.00 <br /> 129/2015 2360 ADDITIONAL UST 4f1.LV $ 130.00 <br /> 129/2015 2362 UST FACILITY 8 1 TANK CC//rr__ $ ren 550.00'' <br /> 129/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FE $ 35.00� <br /> 4 ,y To I forthis Invoice $ 1,188.00' <br /> /i<Due Date 21282015 <br /> //�✓�. TOTAL DUE this Billing Period �$ 1,391.00 <br /> } <br /> � IS <br /> Please make Checks PAYABLE to: 'EHD' – Return a Copy of This STATEMENT with Yodr PAYMENT <br /> Penalties will be added to all Permit Fees For HMBP 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 />