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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMFNT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0017960 <br /> Facility ID FA0010960 <br /> Date Printed 2/18/2010 <br /> HERTZ EQUIPMENT RENTAL - FC RE : HERTZ EQUIPMENT RENTAL - FC <br /> 11285 VALLEJO CT 11285 VALLEJO CT <br /> FRENCH CAMP, CA 95231 FRENCH CAMP, CA 95231 <br /> OWNER : HERTZ CORPORATION <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0198231 ---Date of Invoice: 2/2/2010 1MIT 11111 111 11111 11111 11111 11111 11111 11111 11111 11111 1111�1111 111111 IHI IIII IN <br /> 2/1/2010 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 375.00 <br /> 2/1/2010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 2832 AST FAC 10 K-</-100 K GAL CUMULATIVE $ 337.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 2/15/2010 9997 CORRECTION TO A CHARGE ($ 337.00) <br /> Total for this Invoice $ 637.00 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 637.00 <br /> � D <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/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 /> �254.rpt <br />