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SAN JOAQUIN COUNTY , Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMEP <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE COPY ; �� Account ID AR00169 66 <br /> l• FacilityIID FA0009986 <br /> Date Printed 5/30/2012 <br /> GOLDEN GATE ORN IRON WORKS RE : GOLDEN GATE ORN IRONWORKS <br /> 2489 E MINER AVE 2489 E MINER AVE <br /> STOCKTON, CA 95205 STOCKTON, CA 96205 <br /> OWNER : VALENZUELA,JESUS T <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0223760---Date of Invoice: 1130/2012 IIIIIIIIIIIIIII VIIVIIIVIIIVIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIVIIIIIIIII <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 285.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 788.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 788.50 <br /> PAEST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <br /> in q0 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 />