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Orth JUAWUHN i V VN I r Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF"T <br /> 304 E WEBER AVE - 3RD FLOOR Ifto <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 COPY <br /> INVOICE AccountlD AR0006208 <br /> Facility ID FA0005584 <br /> Date Printed 1/30/2006 <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# IN0142669—Date of Invoice: 1/27/2006 1111111111111111111111111 IN IN <br /> 1/27/2006 2220 SM HW GEN<5 TONSNR $ 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 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <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 Invoice $ 1,209.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period <br /> s(D t-I <br /> RECT FEBQ (JO& FEB 1 5 '9 <br /> SAN <br /> NVIRONMENTA N ry <br /> HEALTH DEPARNiENT <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 /> _23 rpr <br />