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JAN JUAUUIN UUUN I T Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMEb. <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE copy Amount ID AR0024215 <br /> COPY <br /> 1 V` Facility l0 FA0014262 <br /> Date Printed 5/30/2012 <br /> GOMEZ,JOSE RE : JOES AUTOMOTIVE OF LODI <br /> JOES AUTOMOTIVE OF LODI 200 COMMERCE ST#101 <br /> 200 COMMERCE ST#101 LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : GOMEZ, JOSE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND223976--Date of invoice: 1/30/2012 IIIIIIIIIIIIIIIVIIIVIIIIIIIIIIiIIIIIIIIIIIIIIVIIIVIIIIIIIIIIIIIu IIIIIIIi <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 115.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 11.50 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 601.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 601.50 <br /> PAST ®U E <br /> Delinquent charges <br /> will be forwarded to <br /> CO LLECTOONS <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, Rata 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 Dale 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />