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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTI VT 9 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0003663 <br /> Facility ID FA0004027 <br /> INMEMMEMMMEMMI <br /> Date Printed 1/24/2005 <br /> HENDRIX FORKLIFT SERVICE INC RE : HENDRIX FORKLIFT INC <br /> PO BOX 5217 103 N E ST <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : HENDRIX, RICHARD <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0130318--Date of Invoice: 1/24/2005 1111111111111111111111111 IIH 1111111111111111111 <br /> 1/24/2005 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24DO <br /> Total for this Invoicel $ 74.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 74.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 7 2005 <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 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 thereafter <br /> ilii rpt <br />