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SAN JOAQUIN COUNTY . Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME r <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE � AccountlD AR0018279 <br /> COPY � °` � <br /> Facility ID FA001 2279 <br /> Date Printed 5/30/2012 <br /> Immoommoommommom <br /> CUSTOM METAL FINISHING RE : CUSTOM METAL FINISHING <br /> 1550 SHAW RD#C 1550 SHAW RD C <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : CUSTOM METAL FINISHING <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0223693---Date ofInvoice: 1/30/2012 IIIIIIIIIIIIIIIVIIVIIIVIIIVIIVIVIIIVIIVIIIIIIIIIIIIIIIIIIIIVIIIIIIII <br /> 1/27/2012 2227 GEN 5<25 TONS PERMIT $ 1,672.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 360.00 <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 $ 36.00 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 1,672.00 <br /> Total for this Invoice $ 3,769.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 3,789.00 <br /> PAST DUE <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <br /> in 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 />