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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM—"- <br /> 304 E WEBER AVE - 3RD FLOOR _. <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017966 <br /> FacilityID FA0010966 <br /> Date Printed 2/12/2007 <br /> CONCRETE INC RE : CONCRETE INC <br /> PO BOX 66001 851 E LODI AVE <br /> STOCKTON, CA 95206 LODI, CA 95240 <br /> OWNER : KNIFE RIVER COAL MINING <br /> Health <br /> Date Program Description Amount <br /> Invoice# I N0157161 ---Date of Invoice: 1/2512007 11111111 111111 III VIII VIII VIII VIII VIII VIII VIII VIII VIII 11111111111 IIII IIII <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 435.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 665.00 <br /> Payment Due Date 2/25 1 —i <br /> �� 1 <br /> TOTAL DUE this Billing Period $ 66.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 12 2007 <br /> SAN JOAOUIN COUNTY <br /> 0EALT RI 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 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 />