Laserfiche WebLink
CPG-# TO: �FICE OF REVENUE AND RECOVERY <br /> ACCOUNT TRANSMITTAL .1 COPY ACCOUNTNO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> PASQUALA&ANGEL'S MARBLE INC <br /> C/O NAME J GUARANTOR SSN <br /> PASQUALA&ANGEL'S MARBLE INC <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 4025 ARCH RD STOCKTON CA 95215 209-463-8265 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 4025 ARCH ROAD STOCKTON CA. 95215 209-463-8265 <br /> nms— <br /> USER REFERENCE NO. I BILLI STAI CYCLEI STATUS DATEI BMd CBMC INT I MONTHLY PAY AMT <br /> 12887 HAZMAT I I I I I I I I I I I I I I I I I I I j 3/15/08 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> DOB <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NO <br /> 230 026000.0 2008 Hmmp Annual Fee $240.00 <br /> 3 Chems @ $15.00 Each $45.00 <br /> 10% Late Charge $28.50 <br /> State Service Fee $24.00 <br /> Sm Hz Gen <5 Tons/yr $213.00 <br /> Permit Fee Penalty $213.00 <br /> TOTAL $763.50 <br /> GUARANTOR <br /> DOB I DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY I ST ZIPCODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> PASQUALA&ANGEL'S MARBLE INC 209-463-8265 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4025 ARCH RD STOCKTON CA 95215 <br /> SPe OB CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> PASQUALA&ANGEL'S MARBLE INC 209-463-8265 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4025 ARCH RD STOCKTON CA 95215 <br /> PREPARED BY CHECKED B �9 _ DATE D COL. 20 (388 <br />