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SANJOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF"T <br /> 600 E MAIN STREET — RECEIVED <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 APR 2 0 2009 <br /> INVOICE <br /> Account ID AR0028865 <br /> SAN JOAOUIN COUNTY LUMOMMOMMEEMA <br /> OFFICE OF EMERGENCY SERVICES Facility ID FA0016404 <br /> Date Printed 3/25/2009 <br /> A&D RUBBER PRODUCTS CO INC RE : A&D RUBBER PRODUCTS CO INC <br /> 1438 <br /> , CA 95204 <br /> OWNER : A&D RUBBER PRODUCTS CO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0185913—Date of Invoice: 1/29/2009 I Illilll lllill11111111111111111111111llill111111111111111111111111llilll1111111111111 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 360.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 36.00 <br /> Total for this Invoice $ 420.00 <br /> Payment Due Date 2/28/2009 <br /> TOTAL DUE this Billing Period $ 420.00 <br /> LOUE <br /> Delinquent chl_r9es <br /> will be jomarded to <br /> COLLECT5 <br /> in 30 days. <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 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 /> 5254.rpt <br />