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------------- <br /> ._ ..... ........... ------------ <br /> SAN <br /> _____ ____SAN JOAQUIN COUNTY • <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account AR0035752 <br /> Facility ID FA0020057 <br /> Date Printed 3/28/2012 <br /> REYNOSO, MARIO RE : R&S TRANSMISSION <br /> R&S TRANSMISSION 24572 S MACARTHUR <br /> <br /> <br /> OWNER : REYNOSO, MARIO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0226301 ---Date of Invoice: 1/30/2012 Illlilll1111illlllillllull IIIII 111111111111111 IMI IIII IN <br /> 1!2712012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 85.00 <br /> 1/2712012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3115/2012 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Total for this tnvoice $ 355.50 <br /> Payment Due Date 2129/2012 <br /> TOTAL DUE this Billing Pedocil $ 355.50 <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 />