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JAN JUAUUIN GUUN I Y Page 1 <br /> ENVIRONMENTAL HEALTH DEPART <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE AccountID AR0004645 <br /> Facility ID FA0002463 <br /> Date Printed 1/3 012 0 0 6 <br /> FOOD 4 LESS RE : FOOD 4 LESS <br /> 8014 LOWER SACRAMENTO RD#1 678 N WILSON WAY <br /> STOCKTON, CA 95210 STOCKTON, CA 95205 <br /> OWNER : PAQ INC <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0143363--Date of Invoice: 112712006 IIIIIIIIIIIIIVIIIVIIIVIIIVIIVIIVIIIVIIVIIVIIIIIIIIVIIIIIIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 85.00 <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 6 1 TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 964.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 964. <br /> PAYM� <br /> ZO <br /> FEB 1 5 <br /> SAN JOAOUIN <br /> H€q/ '"7!NVMENI. <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 I 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 />