Laserfiche WebLink
SAN JOAUUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTf IT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0006208 <br /> Facility ID FA0005584 <br /> Date Printed 1/29/2009 <br /> VALLEY PACIFIC PETROLEUM SERVICES RE : VALLEY PACIFIC PETROLEUM SERVICES <br /> 188 FRANK WEST CIR 930 E VICTOR RD <br /> STOCKTON, CA 95206 LODI, CA 95240 <br /> OWNER : CRUM, NORM <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0183974---Date of Invoice : 1/29/2009 IIIIIII VII VIIVIIVIIVIIIIIIIIVIIIVIIIIIIIIIIIIIiIIIIIIIIIIIIII <br /> 1/29/2009 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 300.00 <br /> 1/29/2009 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/29/2009 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/29/2009 2360 ADDITIONAL UST $ 125.00 <br /> 1/29/2009 2362 UST FACILITY&1 TANK $ 550.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,242.00 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 1,242.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 9 2009 <br /> RECD FEB 04 2009 SAENVVIIRONIM NOTALTM <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 DES/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 /> '_?4 rpt <br />