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SAN.JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM�T • <br /> 1600 E MAIN STREET <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209) 468-3420 11 J• <br /> INVOICE *. 1 ft 'N` Account ID AR0035516 <br /> ill l Facilityll) r FA0019937 <br /> Date Printed 4/28/2011 <br /> IMPERIAL AUTO SPA RE : IMPERIAL AUTO SPA <br /> 1211 S TURNPIKE RD 1211 S TURNPIKE RD <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : FRANK REYNOSO <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0213830---Date of Invoice: 1/31/2011 IIIIIIIIIIIIIIIIIIIVIIIIII VIIVIIIVIIIIIIIIIVIIIIIIIIIVIIIIIIIIII <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 85.00 <br /> 1/26/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2011 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Total for this Invoice $ 142.50 <br /> Payment Due Date 31212011 <br /> TOTAL DUE this Billing Period $ 142.50 <br /> 6elinquent Chargee <br /> vvill ,Jrwarded to <br /> ip oo 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 />