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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART91T • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0016212 <br /> Facility ID —FA0009212 <br /> Date Printed 2/16/2005 <br /> LEPRINO FOODS CO RE : LEPRINO FOODS CO <br /> 2401 MAC ARTHUR DR 2401 MACARTHUR DR <br /> TRACY, CA 95376 TRACY, CA 95376 <br /> OWNER : LEPRINO FOODS <br /> Date Health <br /> Program Description Amount <br /> Invoice IN0128780--Date of Invoice : 1/2412005 11111111111111111111 IN IN <br /> 1/24/2005 2214 CalARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 690.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 1,184.00 <br /> Payment Due Date 2/2312005 <br /> TOTAL DUE this Billing Period 1,184.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 6 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 /> 5255.rpt <br />