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SAN JUAUUIN CUUN I Y Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMEtmv <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 / <br /> INVOICE 0, 10 Account ID AR0017162 <br /> COPY <br /> Facility ID FA0010162 <br /> Date Printed 5/30/2012 <br /> MARTIN, WADE RE : OFF ROAD ENTERPRISES <br /> 2953 CHERRYLAND AVE#B 2953 CHERRYLAND AVE B <br /> STOCKTON, CA 95215-2233 STOCKTON, CA 95215 <br /> OWNER : MARTIN, WADE <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0223511 --Date of Invoice: 1130/2012 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIVII VIIIIII'/VIII VIIIIIIIIIIIIIIIIIIIIII/III/III <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 285.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/2712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/1512012 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total torthls Invoice $ 788.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 788.50 <br /> PA%'-r.='1)iT 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 I HMMP Fees For all SERVICE FEES <br /> at the Rate p_f,100%,o1„t.,he,l3ase_�r4@rye®c2enalR4e5„vjj bgagded atth.�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 />