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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEP Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID <br /> I FA0003284 <br /> Date Printed 2/28/2006 <br /> lommonommommoun <br /> L-AL-J06fNDER- RE : EAST-FREM6NT-F6 <br /> EAST-Ff2EMON3'-FOGD MARfi& GASII[JN 2185 E FREMONT ST <br /> I-T56-N-WILSGWWA�L STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : L-At;76GtND€R <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN01"527—Date of Invoice: 1/2712006 11111111111111111111 IN 1111 <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 100.00 <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 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2005 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 $ 1,119.00 <br /> .p Payment Due Date 3/1/2006 <br /> NO <br /> ® ICE TOTAL DUE this Billing Period $ 1,119.00 <br /> ' 1. <br /> SAN.IU:.CPJ!A. U.✓.0"t <br /> ENV`i,C NW.'NTAL <br /> HEAt_Th;r:FP�F'1vIENl <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.rpt <br />