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iOAQUIN COUNTY PUBLIC HEAT TH SERVICES Page 1 <br /> ✓IRONMENTAL HEALTH DIVISIC <br /> A E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR0003179 <br /> Facility ID FA0003601 <br /> Date Printed 4/24/00 <br /> ENVIRONMENTAL HEALTH&SAFETY RE: ARCO STATION#5469* <br /> WIGHT,COLLINS 130 S WILSON WY <br /> PO BOX 6038 <br /> ARTESIA CA 907026038 OWNER: WIGHT,COLLINS <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0069471 ---Date of Invoice: 4/19/00 <br /> 4/15/2000 9991 Credit Adjustment -$10.00 <br /> 4/19/2000 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 4/19/2000 2360 Underground Storage Tank EH Operating Permit Fee Tank#001 $170.00 <br /> 4/19/2000 2360 Underground Storage Tank EH Operating Permit Fee Tank#002 $170.00 <br /> 4/19/2000 2360 Underground Storage Tank EH Operating Permit Fee Tank#003 $170.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $610.00 <br /> Payment Due Date 5/24/2000 <br /> TOTAL DUE this Billing Period $610.00 <br /> Please make Checks PAYABLE to : PHS/EHD /, Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PAY w) r <br /> tay ZA, <br /> SAN JOAQUIN COUNTY <br /> pUBUi,HEAL F�7rt'*CES <br /> ENVIROW..t <br /> 5255.rpt <br />