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SAN JOAQUIN COON FY <br /> ENVIRONMENTAL HEALTH DEPARTMEO Page 1 <br /> 304 E WEBER AVE -3RD FLOOR f <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0017994 <br /> LUMMOOMMMMENN <br /> Facility 10 FA0010994 <br /> 7-1 <br /> Date Printed 1/26/2007 <br /> B&B TIRE & SERVICE RE : B&B TIRE & SERVICE <br /> 600 W LOCKEFORD ST 600 W LOCKEFORD ST <br /> LODI, CA 95240 LODI, CA 95240 <br /> OWNER : L BRET DEBERRY <br /> Date Health <br /> Prooram Description Amount <br /> Invoice# IN01 56984—Date of Invoice: 1/2512007 (II II IIIIII III VIII VIII VIII VIII VIIIVI VIII VIII VIII IIII IIIIII IIIII IIII IIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 130.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forthis Invoicel $ 360.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period I $ 360.00 j <br /> PAYMENT <br /> RECEIVED <br /> MAR 07 2007 <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 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 /> 5254.rpt <br />