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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTP'— Page 1 <br /> 304 E WEBER AVE -3RD FLOORi <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0006129 <br /> Facility ID FA0005534 <br /> Date Printed 1/24/2005 <br /> HARBIR S BAL RE : THE SERVICE STATION <br /> THE SERVICE ST TION 1100 W 11TH ST <br /> 1100 W 11TH ST TRACY, CA 95376 <br /> TRACY, CA 95376 <br /> OWNER : BAL, HARBIR S <br /> Date Health <br /> Program Description{ Amount <br /> Invoice# IN0128612---Date of Invoice : 1/24/2005 111111111111111111111111 IN <br /> 1/24/2005 2220 SM HW G N<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZ AT FEE $ 130.00 <br /> 1/24/2005 2399 UNIFIED ROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 354.00 <br /> Payment Due Date 2/23/2005 <br /> ,1 <br /> TOTAL DUE this Billing Period $ 354.00 <br /> 11AL-i ©W, NG, <br /> REOEIVED <br /> 0 <br /> b <br /> L � ApR 1 2005 <br /> SAN!OAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PA ABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OES 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 /> 525i.rpt <br />