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Jun 23 14 04:29a Reliable Petrolar.m 20QR458953 p.2 <br /> Official Payments- Pay Tam,Utility Bills,Tuition& More Online *-moo Page 1 of 1 <br /> This is a"printer friendly"page. Please use the"print'option in your browser to print this screen. <br /> 1 Yui E N <br /> OFFICIAL <br /> fiW <br /> San Joaquin County - Environmental Health Department, CA <br /> Environmental Health Fees <br /> Confirmation Number: 0947DG ` <br /> Payment Date: Monday,June 23,2014 <br /> Payment Time: 02:23PM PT JUN 2 3 2014 <br /> Payer Information <br /> ENVIRONMENTAL <br /> Name: Sandra Barnhart <br /> DEPARTMENT <br /> Street Address: 11930 Horseshoe Road <br /> oakdale,CA 95361 <br /> United States <br /> Daytime Phone (209)845-8586 <br /> Number: <br /> E-mail Address: reliablepeiro@sbcglobal.net <br /> Please provide as much information as possible beau so that we may identify your payment <br /> Address of Facility <br /> where work is being 3440 E.Main Street <br /> done: <br /> Buisness Name: United Gasoline <br /> Additional Information: Contractor, Reliable Pat-oleum <br /> Card Information <br /> Card Type: Visa <br /> Card Number: '""**--*"9022 <br /> Expiration Date: 05!2016 <br /> Payment Information <br /> Payment Type: Environmental Health Fees <br /> Payment Amount: $375.00 <br /> Convenience Fee: $10.95 <br /> Total Payment: $385.95 <br /> Thank you for using Official Payments. If you have a question regarding your payment, please call us toll free at <br /> 1-800-487-4567.To make payments in the future,please visit our website at www.officialpayments.com. <br /> 9 <br /> Copyright 3�2014 Official Payments Corporation.All Rights.Reserved. <br /> O ficial Payments Corporation is a licensed money transmitter in 44 states,the District or Columbia,and Puerto Rico. <br /> Official Payments is not requited to be licensed as a money transmitter in Indiana,Massachusetts. Montana, New klexico, <br /> South Carolina or VAsconsin. <br /> https://wwtv.officialpayments.cornfpc_step6_print.jsp?JSESSIO-NID=pbgvTyYp4d 1 LkxJ!-... 6/23/2014 <br />