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rdye <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE y� D Q Account ID AR0025636 <br /> 1 Facility ID F FA0015000 <br /> /t Date Printed F 5/27/2009 <br /> LODI GRADING & PAVING INC RE : LODI GRADING & PAVING INC <br /> <br /> LODI, CA 95240 <br /> OWNER : MICHAEL R JENNINGS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0185715—Date of Invoice : 1/29/2009 IlilllllllllliullllVlllllllllllillllllllllllplllplllpl <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 330.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 33.00 <br /> 4/15/2009 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 813.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 813.00 <br /> PiA U <br /> Dara i�I�.tient 1r6�akfx2S <br /> Wf ' -s '�;'5}`iv_31"V..E- AQ' <br /> 'rr. 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 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 />