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■i Ac r. 17. 20''5 ''0;014"x/ <br />i ,AN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPART&. T <br />■i 868 E HAZELTON AVENUE <br />■■ 'TOCKTON, CA 95205 <br />Phone, (209) 468-3420 <br />INVOICE <br />VERIZON WIRELESS <br />ENVIRONMENTAL COMPLIANCE <br />255 PARKSHORE DRIVE <br />FOLSOM, CA 95630 <br />RECEIVED <br />APR 17 2015 <br />ENVIER RMIT SERVICESLTH <br />No. 0319 P. <br />Page 1 <br />Account ID <br />AR0041912 <br />FadIlly ID <br />FA0022846 <br />Date Printed <br />4/13/2015 <br />RE: VERIZON WIRELESS. ELDOPVINE <br />3535 N EL DORADO ST <br />STOCKTON, CA 95204 <br />OWNER : VERIZON WIRELESS <br />Date Health <br />Program Description Amount <br />Invoice # IN0265323 --- Date of Invoice : 4/1312015 <br />4/13/2015 1921 HMBP-Regular-Primary Location <br />4/13/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />�'bo Y'G) <br />1 <br />P6&ae <br />name -b <br />1111111111111111 l u l l 1111111111 I l l l i l l l l l 111111111111111111111111111111111111111 I l l i <br />$ 270.00 <br />$ 35.00 <br />Total for this Invoice $ 305.00 <br />Payment Due Date 5113/2015 <br />TOTAL DUE this Billing Periodl $ 305.00 <br />NNCA I�l`� 39� <br />�►do Pine <br />qtce)-35-7 f5 -U-'-'-) <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />lenalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES <br />at the Rate of 100% of the Base Fee Penalties will be added at the Rate of 10% Penakles will be added at the Rate of 10% <br />R e C? I V? d TIM ?:h A p r. 17, 20 15 1 0; 0 5 AMDN 0. 8539'a Invoice Date 60 Days after the Involce Date and each 30 Days thereafter <br />5254 -rot <br />