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SAN JJAQUIN COUNTY <br />ENVIRONMENTAL'HEAL i H DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />AccountlD <br />INVOICE \ /—�� O�� <br />Facility ID <br />Date Printed <br />WESTERN BUILDING MATERIALS CO <br />4620 E OLIVE AVE <br />FRESNO, CA 93702 <br />Page 1 <br />AR0020263 <br />FA0012406 <br />2/28/2017 <br />�i <br />(2401 <br />ESTERN BUILDING MATERIALS CO <br />STAGECOACH RD <br />OCKTON, CA 95215 <br />OWNER: WESTERN BUILDING MATERIALS CO <br />Date Health <br />Drnnram Descrintion Amount <br />Invoice # ING288407 --- Date of Invoice : 1/26/2017 <br />1/26/2017 1921 HMBP-Regular-Primary Location <br />1/26/2017 1922 CERS Processing Fee <br />1/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII <br />$ <br />IIIIII VIII IIII IIII <br />374,00 <br />$ <br />25,00 <br />$ <br />35.00 <br />Total for this Invoice I $ 434.00 <br />Payment Due Date 2/25/2017 <br />TOTAL DUE this Billing Period $ 434.00 <br />REVIEW & RETURN <br />DATE <br />INITI IS <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 HMBP 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 />;2>l rpt <br />