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CIYY IRv1Y1p GI\I l9L�LI"�L 1 rt vLr A1\ mud <br /> 600 E MAIN STREET • • <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-420 \ ✓1 <br /> INVOICE 1� �t I Account ID AR0035525 <br /> Facility ID FFTO019946 <br /> Date Panted 11/30/2009 <br /> ORTEGA ROAD SERVICE RE : ORTEGA ROAD SERVICE <br /> 1759 MARIPOSA RD STE B 1759 MARIPOSA RD STE <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : JOSE LUIS ORTEGA <br /> Date Health <br /> Program Description Amount <br /> Invoice tt IN0194031 —Date of Invoice: 9/24/2009 IIIIIII'IIIII'III�IIIVIIIVII IIIIIIIIIIIIII'lII IIIIIII'lIIIII <br /> 9/24/2009 2244 2009 HAZMAT FEE $ 85.00 <br /> 11/15/2009 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Total forihls Invoice $ 93.50 <br /> Payment Due Date 10/24/2009 <br /> TOTAL DUE this Billing Period $ 93.50 <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECT MONS, <br /> in 30 lows. <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 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 />