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SAN JOA QUIN COUNTY PUBLIC HE�H SERVICES � Page 1 <br /> ENVIRONMENTAL HEALTH DIVISIL. <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account I1. AR0005769 <br /> Facility I FA0005307 <br /> Date Printed4/24/00 <br /> LMOMMMMMMMA <br /> TED COOPER RE: HOLZ RUBBER CO <br /> HOLZ RUBBER CO 1129 S SACRAMENTO ST <br /> PO BOX 241002 LODI CA 95240 <br /> LODI CA 95240 OWNER: HOLZ RUBBER <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0069706--Date of Invoice: 4119/00 <br /> 4/19/2000 2220 SM HW GEN<5 TONSNR $100.00 <br /> 4119/2000 2231 HAZARDOUS WASTE PBR FACILITY $648.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $758.00 <br /> Payment Due Date 5/2412000 <br /> TOTAL DUE this Billing Periodl x$758.00) <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be addedto all Permit Fees Forall SERVICEFEES <br /> at the Rate of 100%of the Base Fee Penalties will he added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PAYMEIV 1 <br /> RECEIVED <br /> w bi <br /> SAN JOAQUIN COUNTY <br /> PUBUC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 5255.rpt <br />