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03/11/2011 16:12 2094640136 <br /> SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME,- <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> Account ID AR0025645 <br /> INVOICEwe <br /> Fadwq lD FA0015009 <br /> s <br /> M C 2 <br /> Date Pnntod 2!28/2011 <br /> PACIFIC COAST MS INDUSTRIES RE : PACIFIC COAST MS INDUSTRIES <br /> PBOX 1020 3940 COMMERCIAL ST <br /> PA <br /> LEBANON,KY 40033-5020 TRACY,CA 95376 <br /> OWNER : PACIFIC COAST MS INDUSTRIES IN <br /> Health Dote PrrOgiam Amount <br /> Description 11� p �Iy� _ <br /> Invoices IN0212337—Date oflm,oiee: 113112011 III,NINI 111101�II�NRI�NINIIBhI�IMIN�I�ipill <br /> $ 213.00 <br /> 112872011 2220 SM MN GEN<5 TONS/YR $ 28500 <br /> 1!282011 2244 2011 HAZMAT FEE $ 24,00 <br /> 1282011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 25.00 <br /> 1/282011 ERSC ELECTRONIC REPORTING SURCHARGE <br /> Total eor this Imro1C11S 547.00 <br /> Payment Due Date 31212011 <br /> C"OND NOTICE <br /> TOTAL DUE this Billing PeAod $ 547.00 <br /> p MAR 11 2411 <br /> Roil <br /> Oar M43 P' t of bvfhes3 J c¢ 3/11/L0 �� . <br /> IIPCS d0Je Dor Qr[a v,Ir C+ /U.r U.r rG�o�d I <br /> r>Ie4;e SPC toclofe d Cllrr t. 1�E ell k �S r <br /> rokr CollerOff#- PAN lJ c Nil hdarkte J <br /> / Nir,SAj Hilvho 77e -6y� 2/ 09 <br /> frt z:6 <br /> Please make Checks PAYABLE to: 'EHD' Retum a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For DES 1 HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Dox Fee Pomitles will be added at tiro Rate of 10% Penaltles will be added of the Rate Of 10% <br /> 30 Days after the Due Date 45 Days alter the Invoice Date 60 Days after the Irrvoiee Date and each 30 Days theneaner <br /> 5254 tot <br />