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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMJ Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID ARoo,sBo, <br /> Facilitylo FA0009801 <br /> LMMMONEMMMMME <br /> Date Printed 1/26/2007 <br /> DEAN BURNSIDE RE : WOODLAKE CLEANERS <br /> WOODLAKE CLEANERS 2401 W TURNER RD 220 <br /> 2401 W TURNER RD#220 LODI, CA 95242 <br /> LODI, CA 95242 <br /> OWNER : BURNSIDE, DEAN <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0156683---Date of Invoice: 1/25/2007 11111 IN 111111111111111 IN <br /> 1/25/2007 2220 SM HW GEN <5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 255.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 485.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 485.00 <br /> PA <br /> RECE VS'ETND <br /> FEB 2 t 2oor <br /> �UOAQL/ <br /> NAT Al N/vr TY <br /> HDEPpR / <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 I 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 /> —J <br />