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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTNW • <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0026446 <br /> Facility ID I F—F—AO-0-153 3— <br /> Date Printed 5/17/2004 <br /> BENNY, VICTOR RE : BENNY PROPERTY <br /> 1154 SECRET LAKE LOOP 226 MYLAR <br /> LINCOLN, CA 95648 MANTECA, CA 95336 <br /> OWNER : BENNY, VICTOR <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0119805---Date of Invoice: 5117/2004 <br /> 5/17/2004 2300 UNDERGROUND TANK PROGRAM $ 170.00 <br /> 5/17/2004 2300 UNDERGROUND TANK PROGRAM $ 500.00 <br /> 5/17/2004 2300 UNDERGROUND TANK PROGRAM $ 170.00 <br /> 5/17/2004 2300 UNDERGROUND TANK PROGRAM $ 500.00 <br /> 5/17/2004 2300 UNDERGROUND TANK PROGRAM $ 500.00 <br /> 5/17/2004 2300 UNDERGROUND TANK PROGRAM $ 500.00 <br /> 5/17/2004 2301 UST STATE SURCHARGE $ 15.00 <br /> 5/17/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 5/17/2004 9001 BACK FEES AND/OR PENALTIES $ 500.00 <br /> 5/17/2004 9001 BACK FEES AND/OR PENALTIES $ 500.00 <br /> 5/17/2004 9001 BACK FEES AND/OR PENALTIES $ 170.00 <br /> 5/17/2004 9001 BACK FEES AND/OR PENALTIES $ 170.00 <br /> 5/17/2004 9001 BACK FEES AND/OR PENALTIES $ 500.00 <br /> 5/17/2004 9001 BACK FEES AND/OR PENALTIES $ 500.00 <br /> Total for this Invoice $ 4,719.00 <br /> Payment Due Date 6/16/2004 <br /> TOTAL DUE this Billing Period $ 4,719.00 <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 /> S25S.rpt <br />