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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM( <br /> 600 E MAIN STREET "" � ..i <br /> STOCKTON, CA 95202 'RLCEI V r-Lj <br /> Phone: (209)468-3420 L <br /> _ _ , ,� AR0034317 <br /> INVOICE <br /> Account ID <br /> MA <br /> SAN JOAQUIN COUNTY Faulty ID F FA0019303 <br /> )FFICE OF EMERGENCY SERVICES <br /> /yt I Date P,iMed 7/13/2011 <br /> ROOF RANGERS /1 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# IN0213674—Date of involoo: 11312011 IMMININNIMII1IIII 11 Nil Ifuffouul <br /> 1/20/2011 2244 2011 HAZMAT FEE $ 285.00 <br /> 112812011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/20/2011 9987 HaZ Mal Program Penalty Fee $ 28.50 <br /> Total for thta In"IC01 $ 362.50 <br /> PAST DUE <br /> TOTAL DUE thio Billing Period S 362.50 <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> Penattles wig be added to all Permit Fees For DFS/HUMP Fees For all SERVICE FEES <br /> at the Rate of I DD%of the Bas@ Fee Penalties will be added at the Rete of 10% Penalties will be added at the Rate of 101. <br /> 30 Days after the Due Date 45 Days after the Invoice Data 60 Days ager the Irwoice Date and each 30 Days therea <br /> 5254 mt <br />