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SAN s'JAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART IT <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone <br /> <br /> Facility ID FFA001042. <br /> Date Printed F 1/24/2005 <br /> FARMINGTON FRESH SALES LLC RE : FARMINGTON FRESH SALES LLC <br /> 7735 S HWY 99 W FRONTAGE RD 7735 S HWY 99 W FRONTAGE RD <br /> STOCKTON, CA 95215 STOCKTON, CA 95215 <br /> OWNER : FARMINGTON FRESH LLC <br /> Date Health <br /> Program Dgsnriptinn __ Amount <br /> Invoice# IN0128773--Date of Invoice: 1124/2005 IIIIIIII III VIVIII VIIV VIII VIIIVIIVIIVIIIIII IIIIII VIIIIIIIIIII <br /> 1/24/2005 2214 CaIARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 1/24/2005 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 435.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 779.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 779.00 <br /> � �aoC <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 2 2005 <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 DES/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 /> ilii.rpt <br />