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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTME <br /> 304x Awi&ER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 ,� 1 70 <br /> INVOICE 0C'IlvB� �a Account ID AR0016775 <br /> Facility ID F FA0 009775 <br /> LMEOMMMMMEEMill <br /> Date Printed 2/5/2004 <br /> CONCRETE INC RE : CONCRETE INC -STKN-STANISLAUS <br /> PO BOX 66001 749 S STANISLAUS ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : KNIFE RIVER COAL MINING <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115786—Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 360.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 584.00 <br /> Payment Due Date 3/612004 <br /> TOTAL DUE this Billing Period $ 584.00 <br /> Amount$ FPA.ou <br /> Dept/GL# `� <br /> Approval <br /> ENURED FEB 1 3 2004 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 6 2004 <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 />