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SAN JUAQU1N UL)UN I Y <br /> ENVIRONMENTAL HEALTH DEPARTMF'._ Page 1 <br /> 304 E WEBER AVE -3RD FLOOR ..0W <br /> PTO 95202 COPY <br /> Phone:e: (209(209)46 46 8-3420 <br /> INVOICE AccountlD FAR0006208 <br /> Lummoommommms <br /> Facility ID FA0005584 <br /> Date Printed 1/26/2007 <br /> Loommounnommomm <br /> VALLEY PACIFIC PETROLEUM SERVICES RE : VALLEY PACIFIC PETROLEUM SERVICES <br /> 188 FRANK WEST CIR 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# IN0166426—Date of Invoice: 1/25/2007 IIIIIIIIIIIIIIVIIIVIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 330.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 1,215.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 1,215.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 200? <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> RECO JAI 3 0 2007 <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 /> 5254 rpt <br />