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SAN JOAQUIN COUNTYPage 1 <br /> ENV9RONMENTAL HEALTH DEPARTMENT <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 /� y <br /> INVOICEy� ✓ Account ID AR0034317 <br /> 1 Facility ID FA0019303 <br /> Date Printed 4/30/2012 <br /> ROOF RANGERS RE : ROOF RANGERS <br /> PO BOX 5114 129 HOOPER DR <br /> GALT, CA 95632 STOCKTON, CA 95203 <br /> OWNER : PATRICK W MAPLE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0226087--Date of Invoice: 1/30/2012 11111p111IN1111p11111p11IN <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 285.00 <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 /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> Total for this Invoice $ 362.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 362.50 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> COL L E ,`IONS <br /> in 30 days. <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 OES I 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 />