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SAN JUAUUIN CUUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTMEJ6 Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0025355 <br /> Facility ID FA0014852 <br /> Date Printed 3/17/2006 <br /> RANCHO SAN MIGUEL INC RE : RANCHO SAN MIGUEL MARKET' <br /> RANCHO SAN MIGUEL MARKET' 610 S CHEROKEE LN <br /> 8014 LOWER SACRAMENTO RD STE 1 LODI, CA 95240 <br /> STOCKTON, CA 95210 <br /> OWNER : QUINN, JOHN F <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0144711 —Date of Invoice: 1/2712006 11p111p11p1111111I 1111111111111111111 <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/2712006 2244 2006 HAZMAT FEE $ 85.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2370 ADDITIONAL UST-1702 COMPLIANT $ 125.00 <br /> 1/27/2006 2372 UST FACILITY&1 TANK-1702 COMPLIANT $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this invoice $ 964.00 <br /> Payment Due Date 3/1/20061 <br /> TOTAL DUE this Billing Period $ 964.00 / <br /> MAR 17 <br /> SAN JOAOUIN CG N i <br /> ENVIRONMENTAL <br /> HEALTH DEP.A.RT.MEN''' <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 SERVIC7ES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% Penalties will beadded Rate of10;thereafter 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date anh 30 Days <br /> 5254.rpt <br />