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5AN JUAUUIN GUUN I Y 1 <br /> ENVIRONMENTAL HEALTH DEPARTMV Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKPhone: ON,209 46 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Amount ID AR0009105 <br /> Facility ID IF—FA0006423 <br /> Date Printed F 1/30/2006 <br /> LEE, JEAN HYUN RE : UNITED GAS <br /> UNITED GAS 3440 E MAIN ST <br /> 3440 E MAIN ST STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : LEE,JEAN HYUN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND143437--Date of Invoice: 1/2712 00 6 i ll ll l lull llli llillulllul VIII VIII IIIIIIIIIIIII III IIIIi IIII IIIIIIIIillll <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 85.00 <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 B I TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Involcel $ 1,104.00 <br /> Payment Due Date 3111200 <br /> TOTAL DUE this Billing Period JET 4.00 <br /> RECE <br /> FEB 13 > <br /> SAN JOAQUIN COUNTY <br /> ENVIRON.MFA;TAL <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 1 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 />