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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTI "T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> @@AccountID <br /> LJ �/�INVOICE IIuUrJ\\1ILL''IIII// AR0016240 <br /> Facility ID FA0009240 <br /> LEMMOMOMMOMME <br /> Date Printed F 2/27/2004 <br /> ELITE CLEANERS RE : ELITE CLEANERS <br /> 3201 W BENJAMIN HOLT DR#119 3201 W BENJAMIN HOLT DR 119 <br /> STOCKTON, CA 95219 STOCKTON, CA 95219 <br /> OWNER : PATEL, GIRA <br /> Date Health <br /> Program Description. Amount <br /> Invoice# IN0115580--Date of invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 255.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 479.00 <br /> Payment Due Date 316/2004 <br /> TOTAL DUE this Billing Period $ 479.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR 5 2004 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <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/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 /> 5255.rpt <br />