Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART . Page 1 <br /> 304E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0001704 <br /> Facility ID FA0001705 <br /> Date Printed 1/30/2006 <br /> COSTCO WHOLESALE #38 RE : COSTCO WHOLESALE#38 <br /> 999 LAKE DR 1616 E HAMMER LN <br /> ISSAQUAH, WA 98027 STOCKTON, CA 95210 <br /> OWNER : COSTCO WHOLESALE CORPORATION <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0143286---Date of Invoice : 1/27/2006 IIIIIIIIIIVIIVI VIIIVIIVIIIIIIIIIIIVI VIII VIIIIII VIII VIII <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 690.00 <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 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2370 ADDITIONAL UST-1702 COMPLIANT $ 125.00 <br /> 1/2712006 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 $ 1,709.00 <br /> Payment Due Date311/20 <br /> TOTAL DUE this Billing Period $ 1,709.00 <br /> PAYIviE111 i <br /> RECEIVEi:? <br /> r EB 1 ¢ 2006 <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 DES 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.rpt <br />