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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />AMENDED <br />INVOICE <br />WONGS DIESEL SERVICE <br />PO BOX 30524 <br />STOCKTON, CA 95213 <br />Page 1 <br />Account ID AR0016564 <br />Facility ID F FA0009564 <br />IVEMMMMMMMEN <br />Date Printed F 11/8/2017 <br />RE: WONGS DIESEL SERVICE <br />1856 N BROADWAY AVE <br />STOCKTON, CA 95205 <br />OWNER: SIRIWAN WONG <br />Date Health <br />Program Description Amount <br />Invoice # IN0297874 --- Date of Invoice : 9/26/2017 <br />9/26/2017 <br />1921 <br />HMBP-Regular-Primary Location <br />RE: WONGS DIESEL SERVICE <br />1856 N BROADWAY AVE <br />STOCKTON, CA 95205 <br />OWNER: SIRIWAN WONG <br />Date Health <br />Program Description Amount <br />Invoice # IN0297874 --- Date of Invoice : 9/26/2017 <br />9/26/2017 <br />1921 <br />HMBP-Regular-Primary Location <br />9/26/2017 <br />1922 <br />CERS Processing Fee <br />9/26/2017 <br />2227 <br />GEN 13<25 TONS PERMIT <br />9/26/2017 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />11/8/2017 <br />2220 <br />SM HW GEN <5 TONSNR <br />11/8/2017 <br />APSA <br />APSA SURCHARGE <br />11/15/2017 <br />9997 <br />CORRECTION TO A CHARGE <br />$ <br />415.00 <br />$ <br />25.00 <br />$ <br />1,949.00 <br />$ <br />49.00 <br />$ <br />249.00 <br />$ <br />26.00 <br />($ <br />1,949.00) <br />Total for this Invoice I $ <br />764.00 <br />Payment Due Date 10/2912017 <br />TOTAL DUE this Billing Period $ 764.00 <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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />5254.rpt <br />