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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTROT . Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95A2 <br /> Phone: (209) 468-3420 /� 1AAR 112003 <br /> INVOICE AccountlD F AR0003 4-4 <br /> Facility ID FA0003565 <br /> fi <br /> Date Printed 2/27/2003 <br /> <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : UNIVERSAL SWEEPINGS SERVICES <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0103507--Date of Invoice: 2/27/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR �� a G' I$ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee 41 <br /> 330. <br /> 2/27/2003 2301 UST STATE SURCHARGE 00 t'`) $ 0.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 1,327.50 <br /> Payment Due Date9/ 03 <br /> SEC+Fn TOTAL DUE this Billing Period $ ,327. 0 <br /> ppR <br /> 14: <br /> 2003 f <br /> 3AN JOHEALTH 5 RV CESSION �i�I�- q-� <br /> PUBLIC ,c �Tt - I W� 12 <br /> EPA)IP,O".J"dENTAI. i..A- <br /> P - <br /> lease make Checks PAYABLE to: 'EHD' Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5255.rpt <br />