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SAN JOAQUIN COUNTY <br /> El`VIRONMENTAL HEALTH DEPARTj#T • Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0017987 <br /> Facility ID FA 010987 <br /> Date Printed 2/24/2005 <br /> PACIFIC COAST SUPPLY LLC RE : ANDERSON TRUSS <br /> ANDERSON TRUSS 2050 E LOUISE AVE <br /> 4290 ROSEVILLE RD LATHROP, CA 95330 <br /> NORTH HIGHLANDS, CA 95660 <br /> OWNER : PACIFIC COAST SUPPLY LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice IN0128418---Date of Invoice: 1/24/2005 11111 11111 11111 11111 IN 111111 11111 1111 IN <br /> 1/24,12005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24,12005 2244 2005 HAZMAT FEE $ 315.00 <br /> 1/24,'2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 539.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 539.00 <br /> P�Y�VES <br /> �EB 2 4 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> NEpLTH 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 /> i2S .rpl <br />