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JAN JUAUUIN GUUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTM. • Page 1 <br /> 600E MAI'`v STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 COPY <br /> INVOICE Account ID AR0033301 <br /> Facility ID FA0018756 <br /> Date Printed 2/27/2009 <br /> LOMOMMMMMMMA <br /> TRIUMPHS ONLY RE : TRIUMPH'S ONLY <br /> 1838 VICKI LN 1805 E MARKET ST <br /> STOCKTON, CA 952054270 STOCKTON, CA 95205 <br /> OWNER : BIER, WAYNE <br /> Date Health <br /> Program Description <br /> mount <br /> Invoice# IN0187080—Date of Invoice: 1129/2009 IIIIIIIIIIIIIII VIIVIIIVIIIVIIVIIVIII VIIIVIIIIIIIiIIIIIII VIII IIII IIII <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 100.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 337.00 <br /> Payment Due Date 212812009 <br /> TOTAL DUE this Billing Period $ 337.00 <br /> EUCD TM <br /> wo <br /> ENPE Mt�SER�CES H <br /> Pleas _ <br /> e 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 /> 5254.rpt <br />