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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM[o Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0011639 <br /> Facility ID FA0007486 <br /> Date Printed 1/26/2007 <br /> BHADE, HARJINDER RE : COUNTRY MARKETPLACE <br /> COUNTRY MARKETPLACE 1789 W CHARTER WAY <br /> 1789 W CHARTER WAY STOCKTON, CA 95206 <br /> STOCKTON, CA 95206 <br /> OWNER : BHADE, HARJINDER <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0156953--Date of Invoice: 1/25/2007 IIIIIIIIIIIIII IIIIIIIIIIIII VIII VIII VIII VIIIIIIIIIIIIIIIIIIIIIIIIIIII VIII IIII IIII <br /> 1/25/2007 2220 SM HW GEN c5 TONS/YR $ 206.00 <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 Invoice $ 885.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 885. 0 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 8 2007 <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 DES I 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 />