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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> Phone: 209-468-3420 <br /> INVOICE <br /> Account lD FAR0061M4 <br /> Facility ID FA0001705 <br /> Date Printed 2/6/2002 <br /> ATTN:LICENSING RE: COSTCO WHOLESALE#38 <br /> COSTCO WHOLESALE#38 1616 E HAMMER LN <br /> 999 LAKE DR STOCKTON CA 95210 <br /> ISSAQUAH WA 98027 OWNER: COSTCO WHOLESALE CORPORATION <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0091386---Date of Invoice; 1122/2002 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN<5 TONSNF $200.00 <br /> Total for this lnvolce $217.50 <br /> Payment Due Date 3/8/ <br /> TOTAL DUE this Billing Period $217.50 <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> 9-r�i:JttlVl <br /> RECEIVED <br /> MAR 12002 <br /> y,:N JOAUUIN i;UUN I <br /> 5255.rpt <br />