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-- . ...._. . - <br /> .::. .:.. .....:._::_ _-_-.._....__-..-.....----- <br /> SAN JOAQUIN COUNTY . <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 / / <br /> INWIC V ` Account ID AR0016958Y <br /> ✓ � Facility ID FA0009958 <br /> Date Printed 4/30/2012 <br /> EXEL(IMPERIAL) RE: EXEL(IMPERIAL) <br /> 4512 FRONTIER WAY 3735 IMPERIAL WAY <br /> STOCKTON, CA 95215-9676 STOCKTON, CA 95215 <br /> OWNER : EXEL(IMPERIAL) <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0223966---Date of Invoice: 1130/2012 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIININ <br /> 1/27/2012 2214 CaIARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 345.00 <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 /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 34.50 <br /> Total for this Invoice $ 698.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 698.50 <br /> PAST DUE <br /> Delinquent charges <br /> Will be forwarded to <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 DES 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 />