Laserfiche WebLink
CPG # _ TO: r—vZCE OF REVENUE AND RECOVERY COPY <br /> ACCOUNT TRANSMITTAL <br /> O ...t <br /> ACCUNT NO. DEPT. NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> GOLDEN VALLEY INDUSTRIES <br /> C/O NAME GUARANTOR SSN <br /> GOLDEN VALLEY INDUSTRIES <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> GOLDEN VALLEY INDUSTRIES 4221 E MARIPOSA RD STOCKTON CA 95215 209-939-3370 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 4221 E. MARIPOSA RD STOCKTON CA 95215 209-939-3370 <br /> USER REFERENCE NO. BILL TAT CYCLE STATUS DATE BM CBM INT MONTHLY PAY AMT <br /> T P B <br /> 13583 HAZMAT <br /> 11/15/09 <br /> CHARGES CE <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENNO/NARRATIVE <br /> SERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT. NO. DESCRIPTION AMOUNT HARGE DEPT. NO. DESCRIPTION AMOUNT <br /> Kin230 026000.0 2004 - 2009 Hmmp <br /> Annual Fee $1440.00 <br /> 5 Chems @ $15.00 <br /> Each Year $450.00 <br /> 10% Late Charge $189.00 <br /> TOTAL 1 $2079.00 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GOLDEN VALLEY INDUSTRIES 209-939-3370 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4221 E MARIPOSA RD STOCKTON CA 95215 <br /> SPARS& CO—OWNER <br /> AST FIRST MI TITLE SOC SEC NO. I DOB Dfl LIC NO AUTO LIC NO <br /> I I <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GOLDEN VALLEY INDUSTRIES 209-939-3370 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 4221 E MARIPOSA RD ST CKT CA 95215 <br /> PREPARED I CHECKED BY DATE / /V Col 20 Isreel <br />