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JAN JUAWU1N UUUN I T <br /> ENVIRONMENTAL HEALTH DEPARTMI"" Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0003314 <br /> Facility ID FA0003735 <br /> Date Printed 1/26/2007 <br /> QUICK STOP MART RE : QUICK STOP MART" <br /> 2057 S ELDORADO ST 2057 S EL DORADO ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : SINGH, SUKHINDER/DHILLON, C <br /> Date Health <br /> Program Description _ Amount <br /> Invoice# IN0158118--Date of Invoice: 1/25/2007 11111 11111 11111 11111 IN 111111 11111 IN 1111 <br /> 1/25/2007 2220 SM HW GEN <5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 85.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> PAYME <br /> I vT Total for this Invoice $ 970.00 <br /> RECEIVED Payment Due Date 2/25/2007 <br /> FEB 2 7 200 TOTAL DUE this Billing Period $ 970.0 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> tiEALTH 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 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 />