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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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B
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BOURBON
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1402
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1900 - Hazardous Materials Program
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PR0529920
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BILLING
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Entry Properties
Last modified
10/29/2020 11:17:02 PM
Creation date
6/8/2018 5:33:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0529920
PE
1920
FACILITY_ID
FA0014523
FACILITY_NAME
THANH AUTO REPAIR
STREET_NUMBER
1402
Direction
(none)
STREET_NAME
BOURBON
STREET_TYPE
ST
City
STOCKTON
Zip
95204
APN
11703017
CURRENT_STATUS
Active, billable
SITE_LOCATION
1402 BOURBON ST
P_LOCATION
01
P_DISTRICT
002
Supplemental fields
FilePath
\MIGRATIONS\B\BOURBON\1402\PR0529920\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
6/30/2016 5:26:47 PM
QuestysRecordID
2827831
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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CPC^ # TO: OFFICE OF REVENUE AND RECOVERY 0 <br /> ACCOUNT TRANSMITTAL <br /> ACCOUNT NO. DEPT. f� REFERRAL �� py <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> THANH AUTO REPAIR 1 11 11 j 11 11 <br /> C/O NAME GUARANTOR SSN <br /> MARK HA <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 1402 BOURBON ST STOCKTON CA 95204 209-943-6322 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 5504 RAYANNA DR STOCKTON CA 95212 209-478-2438 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BMC1 CBM INT MONTHLY PAY AMT PYMT PROB <br /> 13887 HAZMAT 3/20/10 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NOMARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT. NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> 230 026000.0 Sm Hw Gen <5tons/yr $213.00 <br /> 2010 Hazmat Fee $115.00 <br /> State Surcharge Fee $24.00 <br /> Electronic Surcharge Fee $25.00 an <br /> Hazmat Penalty Fee $11.50 <br /> Permit Fee Penalty $213.00 <br /> TOTAL $601.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST I ZIP CODE <br /> EMPLOYER NAME <br /> EMPLOYER PHONE NO <br /> THANH AUTO REPAIR 209-943-6322 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1402 BOURBON ST STOCKTON CA 95204 <br /> SPAU&& CO-OWNER <br /> ST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> THANH AUTO REPAIR 209-943-6322 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 1402 BOURBON ST ST CK CA 95204 <br /> REPARED BY CHECKED BY DATE -� 5--/O COL. 20 (3M) <br />
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