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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EMBARCADERO
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6629
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1900 - Hazardous Materials Program
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PR0530826
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BILLING
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Entry Properties
Last modified
10/19/2020 10:08:36 PM
Creation date
6/9/2018 2:13:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0530826
PE
1921
FACILITY_ID
FA0002456
FACILITY_NAME
GARLIC BROTHERS
STREET_NUMBER
6629
Direction
(none)
STREET_NAME
EMBARCADERO
STREET_TYPE
DR
City
STOCKTON
Zip
95209
APN
09815006
CURRENT_STATUS
Inactive, non-billable
SITE_LOCATION
6629 EMBARCADERO DR
P_LOCATION
01
P_DISTRICT
002
Supplemental fields
FilePath
\MIGRATIONS\E\EMBARCADERO\6629\PR0530826\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
6/25/2015 6:10:02 PM
QuestysRecordID
2773665
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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-CPG T0: OFFICE OF REVENUE AND RECOVERY Py <br /> ACCOUNT TRANSMITTALACCOUNT NO. DEPT. NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> GARLIC BROTHERS RESTAURANT & <br /> C/O NAME GUARANTOR SSN <br /> GREGORY RISSO <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 6629 EMBARCADERO STOCKTON CA 95219 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE 8M CBM INT MONTHLY PAY AMT <br /> p7nmATTF <br /> 13848 HAZMAT <br /> 4/15/11 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE Kin DEPT. NO. DESCRIPTION AMOUNT HARGE DEPT, NO. DESCRIPTION AMOUNT <br /> 230 042000.0 2011 Hazmat Fee $255.00 380 042000.0 <br /> 230 042000.0 Haz Mat Penalty Fee $25.50 380 042000.0 <br /> 380 042000.0 380 042000.0 <br /> 380 042000.0 380 042000.0 <br /> 380 042000.0 State Surcharge Fee $24.00 380 042000.0 <br /> 380 042000.0 Electronic Surcharge Fee $25.00 380 042000.0 <br /> 380042000.0 380 042000.0 <br /> TOTAL $329.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GARLIC BROTHERS RESTAURANT& BAR <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 6629 EMBARCADERO STOCKTON CA 95219 <br /> CO—OWNER <br /> ST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GARLIC BROTHERS RESTAURANT& BAR <br /> EMPLOYER STREET CITY EST ZIP CODE <br /> 6629 EMBARCADER TO TON CA 95219 <br /> PREPARED BY CHECKED BY DATE 7 7�� ca. x Iasel <br />
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