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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTF <br />1868 E HAZE; -TON AVENU <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />} <br />� N <br />0 , <br />J <br />G <br />*. <br />52 <br />O <br />ry <br />0,fa <br />v <br />Date <br />a ' <br />\ r� <br />I <br />r, <br />■v . _ <br />CROSSROADS AUTOMOTIVE <br />600 N EL DORADO ST <br />STOCKTON, CA 95202 <br />RE <br />� N <br />� <br />J <br />LAMP <br />H <br />C V <br />TOTAL DUE this Billing Period <br />m m <br />Date <br />Health <br />\ r� <br />I <br />N m <br />IW <br />m a— <br />c = <br />cc <br />m 3: 4 <br />Invoice# IN0261390 --- Date <br />c¢ <br />IIIIIIIIIIIIIIIVIIIVIIIVIIIIIIIIIIIVIIIVIIIVIIIVIIIIIIIIIIIIIVIIIIIIIIIE <br />iy <br />D <br />Z <br />Ci t <br />RE <br />Page 1 <br />Account ID <br />� N <br />Facility ID <br />� N <br />Date Printed <br />\ I <br />TOTAL DUE this Billing Period <br />m m <br />Date <br />Health <br />\ r� <br />I <br />N m <br />Description <br />m a— <br />m 14 = <br />m 3: 4 <br />Invoice# IN0261390 --- Date <br />no m _- <br />IIIIIIIIIIIIIIIVIIIVIIIVIIIIIIIIIIIVIIIVIIIVIIIVIIIIIIIIIIIIIVIIIIIIIIIE <br />1/29/2015 <br />1920 <br />LLI]'Q .-ice <br />Ci t <br />2220 <br />-V <br />2 F -a u .� <br />$ 100.00 <br />M U.100 N <br />2399 <br />m Oc.LL d} ` <br />$ 213.00 <br />CIO _ <br />$ 35.00 <br />W F. F <br />LL 0 <br />2ww to = <br />e_ p9 N G <br />FI_Q m _ <br />rn <br />N <br />n: F- � LLP -_ <br />k. -3 <br />F• N + <br />C( m <br />N - <br />lu <br />n _ <br />H <br />� <br />K <br />N <br />z <br />U <br />to <br />Page 1 <br />Account ID <br />AR0017453 <br />Facility ID <br />F FA 1010453 <br />Date Printed <br />1/29/2015 <br />CROSSROADS AUTOMOTIVE <br />600 N EL DORADO ST <br />STOCKTON, CA 95202 <br />Total for this Invoice <br />$ 348.00 <br />OWNER: <br />BERKEBILE BRENT/FRISB, SHAYLA <br />TOTAL DUE this Billing Period <br />Date <br />Health <br />I <br />Program <br />Description <br />me I <br />Invoice# IN0261390 --- Date <br />of invoice: 1/29/2015 <br />IIIIIIIIIIIIIIIVIIIVIIIVIIIIIIIIIIIVIIIVIIIVIIIVIIIIIIIIIIIIIVIIIIIIIIIE <br />1/29/2015 <br />1920 <br />HMBP-Common Materials <br />1/29/2015 <br />2220 <br />SM HW GEN <5 TONSNR <br />$ 100.00 <br />1/29/2015 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />$ 213.00 <br />$ 35.00 <br />Total for this Invoice <br />$ 348.00 <br />Payment Due Date <br />2/28/2015 <br />TOTAL DUE this Billing Period <br />