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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART T Page 1 <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD ARoo,ssaa <br /> Facility IDFA0009644 <br /> LMMMMMMMMMMA <br /> Date Printed 1/30/2006 <br /> LNEUMMMEMMMEMMA <br /> COX BROS TIRE SERVICE RE : COX BROS TIRE SERVICE <br /> 507E 11TH ST 507 E 11TH ST <br /> TRACY, CA 95376 TRACY, CA 95376 <br /> OWNER : BREITSTEIN, EARL <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142787---Date of Invoice: 1/27/2006 11111111111111111111 IN IIIII 11111111111111111111111111111111 <br /> 1/27/2006 2220 SM HW GEN <5 TONSNR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 100.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoicel $ 324.00 <br /> Payment Due Date 3/1/2006__ <br /> TOTAL DUE this Billing Period $ 324.0 <br /> RF�M�OT <br /> FFB <br /> HTH RT�3yFN2T00 <br /> 6VNR°�N <br /> pFPMN k I <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 I 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 /> 5254.mt <br />