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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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T
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TEEPEE
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2735
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1900 - Hazardous Materials Program
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PR0521157
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BILLING
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Entry Properties
Last modified
10/31/2020 11:27:52 PM
Creation date
6/11/2018 6:06:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
RECORD_ID
PR0521157
PE
1921
FACILITY_ID
FA0014318
FACILITY_NAME
INDUSTRIAL MOBILE SERVICES
STREET_NUMBER
2735
Direction
(none)
STREET_NAME
TEEPEE
STREET_TYPE
DR
City
STOCKTON
Zip
95205
CURRENT_STATUS
Inactive, non-billable
SITE_LOCATION
2735 TEEPEE DR STE B
P_LOCATION
(none)
Supplemental fields
FilePath
\MIGRATIONS\T\TEEPEE\2735\PR0521157\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
10/16/2015 7:55:45 PM
QuestysRecordID
2895348
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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Cp'G# TO: 9FICE OF REVENUE AND RECOVERY •ACCOMT TRANSMITTAL COF <br /> ACCOUNT NO. DEPT.NO. REFERRAL <br /> 026000.0 <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> INDUSTRIAL MOBILE SERVICES <br /> C/O NAME GUARANTOR SSN <br /> JAMES A YATES <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2735 TEEPEE DR #BSTOCKTON CA 95205 209-610-8942 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 13324 LAMBUTH RD OAKDALE CA 95361 209-465-7499 <br /> USER REFERENCE NO. I BILL STA CYCLE STATUS DATE B4 C B M C INT MONTHLY PAY AMT <br /> 10479 HAZMAT I I I I I I I i I I I I I I I I I3/15/08 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NOMARRATIVE <br /> SERVICE DATE-. DATE OF <br /> START STOP11 MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NONO <br /> 230 026000.0 2008 Hmmp Annual Fee $240.00 <br /> 1 Chem @ $15.00 $15.00 <br /> 10% Late Charge $25.50 <br /> State Surcharge Fee $24.00 <br /> TOTAL $304.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY STZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> INDUSTRIAL MOBILE SERVICES 209-610-8942 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2735 TEEPEE DR#B STOCKTON CA 95205 <br /> Sp9SSE CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> INDUSTRIAL MOBILE SERVICES 209-610-8942 <br /> EMPLOYER STREET CITY ST I ZIP CODE <br /> 2735 TEEPEE DR#B STOCKTON CA J95205 <br /> PREPARED BYCHECKED BY DATE n� COL. 20 (3188 <br /> Lro <br />
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