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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600E MAIN STREET COPY <br /> STOCKTON, CA 95202 <br /> 1NV®ICEIt1 Q" lam/ Account IDF—AR0035535 <br /> .2 <br /> Facility ID FA0019956 <br /> Date Printed F 4/30/2012 <br /> SILVESTRE'S CONST MECH CO RE : SILVESTRES CONST MECH CO <br /> PO BOX 2507 6030 E KETTLEMAN LN <br /> LODI, CA 95241 LODI, CA 95240 <br /> OWNER : SILVESTRE HERNANDEZ <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0226244---Date of Invoice: 1130/2012 I IIII VIII III VIII VIII VIII VIII VIII VIII VIII VIII IiI IIII III 11111 1111111 <br /> IIII <br /> 1/27/2012 2214 CalARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE S 24.00 <br /> 1127/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 36.00 <br /> Total for Nis Invoice $ 715.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 715.00 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <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/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 />