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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONRSeNTAL HEALTH DEPARTN +T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account AR001794mmmmommmmoo <br /> llon <br /> Facility ID F FA0010935 <br /> Dale Printed 3/26/2004 <br /> <br /> <br /> STOCKTON, CA 95205 <br /> OWNER : JOSE LUIS LOPEZ <br /> Health Amo <br /> 0M,V unt <br /> Program Oescr; icon <br /> Invoice# IN0116114—Date of Invoice: 2/412004 $ 200.00 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 100.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 24.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 10.00 <br /> 3/21/2004 9987 Haz Mat Program Penalty Fee <br /> Total for this Invoice $ 334.00 <br /> Payment Due Date 31612004 <br /> i \ <br /> TOTAL DUE this Billing Period 334.00 1 <br /> PrAS ! DUE ! PAYMENT <br /> WE WOULD APPRECIATE YOUR RECEIVED <br /> PAYMENT TODAY? <br /> APR 13 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 OES/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% <br /> 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 />