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ENVIRONMENTAL HEALTH DEPARTMF^IT Page 1 <br /> 600 E MAIN STREET C q <br /> STOCKTON, CA 95202 y 1 1 S � a `' COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0025644 <br /> Facility ID F FA0015008 <br /> LEEMMONOMOMMES <br /> Date Panted 3/31/2010 <br /> BARROS AG WELDING AND TRAILER RE : BARROS AG WELDING AND TRAILER REPAI <br /> 1623 THIRD ST 26414 LONE TREE RD <br /> ESCALON, CA 95320 ESCALON, CA 95320 <br /> OWNER : JJGS CORP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0199349---Date of Invoice: 2/2/2010 IIIIIIIIII IIIIII IIIVIIVIIVIIVII VIII VIIIA IIIIIIIIIIIIIIIIIIIIII <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 270.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 27.00 <br /> Total for this Invoice $ 346.00 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 346.00 <br /> Delinquent charges, <br /> will `'ke `:`nr va..rdet„ I,yO <br /> in 30 daYS. v <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/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 />