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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMFO Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0017273 <br /> Facility ID FA0010273 <br /> Date Printed 2/5/2004 <br /> COSTCO WHOLESALE - MEATS#210 RE : COSTCO WHOLESALE - MEATS#210 <br /> <br /> TRACY, CA 95376 <br /> OWNER : COSTCO WHOLESALE CORP <br /> Date Health <br /> ^rogrnm Description Amount <br /> Invoice IN0115968---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2214 CaIARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 495.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total forth is Invoice I $ 989.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 989.00 <br /> RECEIVED <br /> MAR 12 2004 <br /> SAN J0AQUIN C <br /> ENWRONM <br /> ENZAL <br /> OUNTY <br /> FIEgL NDPARTMENT <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 />