Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH" DEPARTP T <br />304 E WEBER AVE - 3RD FLOOR <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />DON HOLSWORTH <br />OUT WEST AUTO <br />720 E LODI AVE <br />LODI, CA 95240 <br />Page 1 <br />Account ID <br />( AR0022800 <br />Facility ID <br />24.00 <br />FA0013644 <br />Date Printed <br />5/23/2006 <br />RE: OUT WEST AUTO <br />720 E LODI AVE <br />LODI, CA 95240 <br />OWNER: HOLSWORTH, DON <br />Date Health <br />Program Description Amount <br />Invoice # IN0143333 -- Date of Invoice : 1/27/2006 <br />1/27/2006 2220 SM HW GEN <5 TONS/YR <br />1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />4/15/2006 9994 PERMIT FEE PENALTY <br />11II11II1111I1 III VIII VIII VIII VIII VIII VIII VIII VIII VIII 1111111111 <br />$ <br />VIII IIII IIII <br />200.00 <br />$ <br />24.00 <br />$ <br />200.00 <br />Total for this Invoice $ 424.00 <br />PAST DUE <br />TOTAL DUE this Billing Period $ 424.00 <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />'enalties 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 thereafte <br />5254.rpt <br />