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rage 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF"T <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0034306 <br /> LIMMEMMENNIMMUMA <br /> Facility ID FA0019292 <br /> Date Printed 12/23/2008 <br /> FERMIN ALUSTIZA RE : FERMIN ALUSTIZA <br /> 8250 SEGARINI CT 820 CHANNEL ST <br /> STOCKTON, CA 95209 STOCKTON, CA 95202 <br /> OWNER : FERMIN ALUSTIZA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0180892--Date of Invoice : 10/2312008 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIN <br /> 10/23/2008 2244 2008 HAZMAT FEE PLUS 2 YEARS BACK BILLING $ 810.00 <br /> 12/15/2008 9987 Haz Mat Program Penalty Fee $ 81.00 <br /> Total for this lnvolce $ 891.00 <br /> Payment Due Date 11/23/2008 <br /> TOTAL DUE this Billing Period $ 891.00 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <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 OES/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.not <br />