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OAN JUHUUIN I.UUN I 1 Nage 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET y <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 COPY <br /> INVOICE a o g AccounttD AR0026837 <br /> Facility ID FA0015546 <br /> Date Printed F 3/31/2010 <br /> Loommummmommomm <br /> JERRY JOY CONCRETE RE : JERRY JOY CONCRETE <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : COLLEEN JOY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IND199413—Date of Invoice : 2/2/2010 � �p�� � �� �11111 HE11111111111111111111111 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 345.00 <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 $ 34.50 <br /> Total for this Invoice $ 428.50 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 428.50 <br /> Pa kU <br /> Delinquent Charges <br /> wM b_c> forward Ddl to <br /> ONS <br /> in, 30 clays. <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 DES 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 />