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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> INVOICE <br /> Account ID AR0030104 <br /> Facility to F FA0017222 <br /> Date Printed F 2/28/2017 <br /> Inummmmmmumi <br /> DEMARTINI & GERLOMES RE : DEMARTINI & GERLOMES <br /> PO BOX 56 8440 N DEMARTINI LN <br /> LINDEN, CA 95236 LINDEN, CA 95236 <br /> OWNER : DEMARTINI & GERLOMES <br /> � <br /> Date Health -- - <br /> L Prnnram. Description. Amount <br /> Invoice# IN0289307---Date of Invoice: 1/26/2017 IIIIIIIIIIIIIIVIIIIIIIIIIIII VIIIVIII VIII VIIIIIIIIIIIII IIIIIIIIIII'IIIIIIIIIII <br /> 1/26/2017 1922 CERS Processing Fee $ 25.00 <br /> 1/26/2017 1958 HM-Farm Operations $ 20.00 <br /> 1/26/2017 2220 SM HW GEN<5 TONS/YR $ 226.00 <br /> 1/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 306.00 <br /> Payment Due Date 2/25/2017 <br /> -- r^-v TOTAL DUE this Billing Period $ 0 .00` <br /> s <br /> Gh�t, >52 0 <br /> 0 <br /> (3._ <br /> G Gi� eeY <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 HMBP 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 /> 5254.rpt <br />