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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTUW R Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0004645 <br /> LMMMMMMONNOWN <br /> Facility ID FA 0-02463 <br /> Date Printed F1/26/2007 <br /> GILBERT SILVA RE : FOOD 4 LESS' <br /> FOOD 4 LESS' 678 N WILSON WAY <br /> 17935 MURPHY PARKWAY STOCKTON, CA 95205 <br /> LATHROP, CA 95330 <br /> OWNER : PAID INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0157197---Date ofInvoice: 1125/2007 11111111111111111111 IN IIIIII IIIII IIII IN <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 85.00 <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 $ 970.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period :$;:97:0:0 : <br /> PAYMENT <br /> RECD VED <br /> FEB 0 9 2L c/ <br /> SAN JOAOUIN 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 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 rot <br />