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SAN JOAOUIN COUNTY *W VAW Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON. CA 95202 <br /> Phone: 209-468-3420 <br /> INVOICE Account ID AR000szoe <br /> Facility ID FA0005584 <br /> Date Printed 2/5/2002 <br /> ACCOUNTS PAYABLE RE: WOOLSEY OIL CO/ROBERTS PETRO <br /> WOOLSEY OIL CO/ROBERTS PETRO 930 E VICTOR RD <br /> 166 FRANK WEST CR LODI CA 95240 <br /> STOCKTON CA 95206 <br /> OWNER: CRUM,NORM <br /> Health <br /> Date Program Description _ Hrs Employee Amount <br /> Invoice# IN0090842•—Date of Invoice: 112212002 <br /> 11222002 2362 Undemround Stomqe Tank EH Operating Permit Fee Tank#006 $500.00 <br /> 1/22/2002 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $17.50 <br /> 1/22/2002 2220 SM HW GEN<5 TONS/YF $200.00 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> 1/22/2002 2360 Undemround Storaqe Tank EH Operatinq Permit Fee Tank#007 $125.00 <br /> 1/22/2002 2301 UST STATE SURCHARGE $10.00 <br /> Total for this Invoice $662.50 <br /> Payment Due Date <br /> TOTAL DUE this Billing Period $862.50 <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 all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Penalties will be addedat the Rate of 10 <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> PAYNI t=IV <br /> RECEIVED <br /> MAR 0 5 2002 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC FNVIRONMFNEALHEALTH LHEATH �DIVISION <br /> 5255.rpt <br />