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SAN JOAQUIN COUNTY -- Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> INVOICE Account ID AR0 116 002 <br /> Facility ID FA0009402 <br /> Date Printed 4/30/2012 <br /> COLLINS ELECTRICAL CO INC RE : COLLINS ELECTRICAL CO INC <br /> 611 W FREMONT ST 611 W FREMONT ST <br /> STOCKTON, CA 95203 STOCKTON, CA 95203 <br /> OWNER : COLLINS ELECTRICAL CO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0223288---Date of Invoice: 1130/2012 111111111111V 1111111111111111111111111111111111111111111111111111111p111p11111 <br /> 1/27/2012 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <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 /> 2/27/2012 9999 PAYMENT ($ 409.00) <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 426.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 426.00 <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 DES 1 HMMP Fees For all SERVICE FEES <br /> at the Rate 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 Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254 rpt <br />