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JAN JUAUUIN UUUIV 1 T <br /> ENVIRONMENTAL HEALTH DEPARTMF Page 1 <br /> 304 E WEBER AVE -3RD FLOOR ' <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0004680 <br /> Facility ID FA0002512 <br /> Date Printed 1/26/2007 <br /> SWARAN CHOUHAN RE : SUPER CENTER MART* <br /> SUPER CENTER MART* 701 E CHARTER WAY <br /> 701 E CHARTER WAY STOCKTON, CA 95206 <br /> STOCKTON, CA 95206 <br /> OWNER : CHOUHAN, SWARAN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0157242---Date of Invoice : 1/25/2007 11111M ET H RE�1111 E��11111 11111 1111 111 1hi�IR IN 11U�1111111 IN <br /> 1/25/2007 2220 SM HW GEN <5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT 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 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 $ 970.00 <br /> Payment Due Date 2/25/ 0 7 <br /> TOTAL DUE this Billing Period $ 970. <br /> �E <br /> g � 6 <br /> 0,000 <br /> JOAQV"N log- <br /> S 'oko PPRT <br /> Nte"' <br /> �,L1H pE <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 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 /> 52>4.rpt <br />