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SAN,JtJAWUIN UL)UN I T Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME"T <br /> 600 E MAIN STREET `. -ftd <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 1 <br /> INVOICE ` Account to AR0035034 <br /> Facility ID FA0019672 <br /> Date Pnnted F 3/31/2010 <br /> LUCERO TRUCKING RE : LUCERO TRUCKING <br /> PO BOX 739 4242 E MARIPOSA RD <br /> LINDEN, CA 95236 STOCKTON, CA 95215 <br /> OWNER : LUCERO, RENE & SILVIA P <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0200821 ---Date of Invoice: 2/2/2010 IIIIIII III II 'VII�III I�IIVII I�IIVIIIVIIVIII IIIIIIIIIIIIIIIIIII <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 /> f-- Total for this Invoice $ 346.00 <br /> Payment Due Date 31412010 <br /> TOTAL DUE this Billing Period $ 346.00 <br /> Delinquent charges <br /> �iviff be forwarded to <br /> ins 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 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 />