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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTME Page 1 <br /> 30,ZE WEBER AVE - 3RD FLOOR �. ✓ <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0004471 <br /> Facility ID FA0002722 <br /> 1►,/ 111Q� Date Printed IF 2/27/2004 <br /> ADDRESS CORRECTION <br /> OMS#24 STATE MILITARY DEPT RE : OMS #24 STATE MILITARY DEPT <br /> PO BOX 269101 ATTN: CAEV BOX 17 8010 S AIRPORT WAY <br /> SACRAMENTO, CA 95826-9101 STOCKTON, CA 95206 <br /> OWNER : STATE MILITARY DEPARTMENT <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115422---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2227 GEN 5<25 TONS PERMIT $ 1,568.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 1,592.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period 1,592.00) <br /> L7 <br /> 3 - <br /> t� <br /> PAYMENT <br /> RECEIVED' o -- <br /> MAR <br /> SAN JOAOUIN f <br /> ENVIRO ' aNME <br /> HEALTH DEPARTMENT <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 DES 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 /> 5.rpt <br />