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ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 500 E MAIN STREET _ <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 COPY <br /> INVOICE 1 �\ Account ID I f AR0028324 <br /> Facility ID FA0016201 <br /> Date Printed F 3/31/2010 <br /> GARCIAS AUTO REPAIR & TOW RE : GARCIAS AUTO REPAIR & TOW <br /> 982 E WATERLOO RD 982 E WATERLOO RD <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : GARCIA LUNA EVARISTO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0199492---Date of Invoice: 2/2/2010 IIIII�II�IVIII 'VIII'lll lllllVIII II�IIIIIIIII)III II1111111111111 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 85.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> Total for this Invoice $ 142.50 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 142.50 <br /> D0'ii"i'i•` '-Jef It charges <br /> 1f1 11 <br /> 11 t;c,, !0rwi3'rde¢:.10-ry to <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 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 />