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JAN JVAt1U1N L:VUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTME' Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR r/ <br /> PTO 95202 COPY <br /> Phone:e: (209(209) 46 46 8-3420 <br /> INVOICE Account ID I ARD009954 <br /> Facility ID FA0006977 <br /> Date Printed 1/30/2006 <br /> lommommomommmma <br /> DAVID ATWATER RE : TIGER EXPRESS #1* <br /> TIGER EXPRESS #1* 5777 S FRENCH CAMP RD <br /> PO BOX 1207 FRENCH CAMP, CA 95231 <br /> STOCKTON, CA 95201 <br /> OWNER : CALIFORNIA FUEL STOPS INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND143466—Date of Invoice: 1/2712006 11111111 HIT 111111111111111111111111111111111111111111111111111111111111111111111111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 285.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2362 UST FACILITY&1 TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,304.00 <br /> Payment Due Date 311/2006 <br /> TOTAL DUE this Billing Period $ 1,344.00 <br /> PAYNlEW <br /> RECEIVED <br /> FEB 14 2000 <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 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 />