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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPAR-r,-NT p <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE ECEIVED <br /> Account ID AR0017207 <br /> FEB <br /> Facility ID FA0010207 <br /> SAN JOAQUIN COL VTY <br /> OFFICE OF EMERGENCY SERVIC&Printed 1/30/2012 <br /> C/O RICHARD GIBSON -LAWYER RE : CARPERS HAY SERVICE <br /> CARPERS HAY SERVICE 17641 FRENCH CAMP RD <br /> 2027 GRAND CANAL BLVD STE 35 RIPON, CA 95366 <br /> STOCKTON,CA 95207 <br /> OWNER : SIDNEY CARPER <br /> Date Health <br /> Program Description <br /> Amount I <br /> Invoice# IN0224249—Date of Invoice: 1/30/2012 IIIIIIIIIIIIIII VIIIVIII ILIIVIIIVIIIIII'(IIII VIIIVIIIIIIIIIIIII 111111111 IIII <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 100.00 <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 /> Total for this Invoice $ 149.00 <br /> Payment Due Date 2/29/2012 <br /> TOTAL DUE this Billing Period $ 149.00 <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/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.ryt <br />