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SAN JOAQUIN COUNTY + <br /> ENVIRONMENTAL HEALTH DEPARTOT • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0004177 <br /> Facility ID FA0004495 <br /> Date Printed 1/24/2005 <br /> RO LAB AMERICAN RUBBER CO RE : RO LAB AMERICAN RUBBER CO <br /> PO BOX 450 8830 W LINNE RD <br /> TRACY, CA 95378-0450 TRACY, CA 95304 <br /> OWNER : RO LAB AMERICAN RUBBER CO INC <br /> Date Health <br /> I <br /> Program Description Amount <br /> Invoice# IN0129042---Date of Invoice: 1/24/2005 � 11111 11111 11111 IEI 11111 ITI 11111 11111 11111 11111 1111 110�1111�IIII IN <br /> 1/24/2005 2227 GEN 5<25 TONS PERMIT <br /> $ 1,568.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 390.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE S 24.0 <br /> Total for this Invoice $ 1,982.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 1,982.00 <br /> �AR _ 7 2005 <br /> SAN JOAC 3m COUNT`! <br /> ENVIR DEPARTMENT <br /> NEALT H <br /> PA AI 15 <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/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 /> ;Z;; rpt <br />