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OAry JUAWUIN UUUNI Y <br /> ENVIRONMENTAL HEALTH DEPARTWfT Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 COPY_ <br /> INVOICE Account ID A 00006941 <br /> Facility ID r F 00006972 <br /> Date Printed 1/30/2006 <br /> TSI TRANS SYSTEM INC RE : TSI TRANS SYSTEM INC <br /> 707 ROTH RD 707 E ROTH RD <br /> FRENCH CAMP, CA 95231 FRENCH CAMP, CA 95231-9774 <br /> OWNER : TSI TRANS SYSTEM INC <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0143057---Date of Invoice: 1/27/2006 11111 11111 IN 111111 11111 1111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 330.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <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 Invoicel $ 1,069.00 <br /> Payment Due Date 3/ <br /> TOTAL DUE this Billing Period $ 1,069.0 <br /> PAYMENIT <br /> FES 2 1 2006 <br /> SAN JOAQUI[!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 />