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EHD Program Facility Records by Street Name
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1621
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3000 – Underground Injection Control Program
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PR0515035
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SITE HISTORY
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Last modified
2/11/2019 3:57:10 PM
Creation date
2/11/2019 3:03:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
SITE HISTORY
RECORD_ID
PR0515035
PE
3030
FACILITY_ID
FA0012021
FACILITY_NAME
WESTERN SQUARE INDUSTRIES INC
STREET_NUMBER
1621
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
1621 N BROADWAY AVE
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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SAN rJ�U. N -06NTY PUBLIC HEALTH SERVICES Report 45255 <br /> ENVT,R- ,N NT HE"ALTH hOIVr,+` N �. St'. Iment Printed : 07 /26/99 <br /> 30� `E E ER A'A NUE — 3RD DR i <br /> STOCKTON C;A 95202 :� <br /> Accountilgio ice : 209 468-34..3.j3lyv <br /> _ <br /> •n 1 <br /> TO : WESTERN SQUARE INDUSTRIES IVC <br /> 1621. .N ErROADWAY AVE Account # 0019074 <br /> { STOCKTON. CA 95205 s <br /> I <br /> � i <br /> AT"TN : WARREN SNIDER ,VP OPERA'IIO-N'S 0� . Facility ID 012021 <br /> -RE LE <br /> rr, <br /> 1521-..N=- BROADWAY AVE <br /> STOCKTON <br /> PLEASE RETURN a Copy OX IS 5TRTE1IENT with fouR PAItMENT <br /> ti Service 4tivity <br /> Date Description Hrs �" Employee '' Amount <br /> Invoice 0. 062433 -- Date of Invoice: 06/01/99. <br /> { 05/11/99 3430 CONSULTATION 0 :'.3 R,LE $23 . 40 <br /> 06/01/99 3030 REPORT REVIEW 1 .`.0 RI WE . $78 . 00 1 <br /> I 06/ 11/99 PAYMENT i $234 . 00 <br /> 06/04/99 3030 REPORT REVIEW. 1 . 0 R,OWE $78 . 00 <br /> 06/08/99 3030 REPORT REVIEW0 .f5 RIWE $39 . 00 <br /> I 05/22/99 3039 FIELD CONSULT 0 .`S R�OWE: $39 . 00 <br /> i Total or this Invoice: " $23.40 t <br /> P.aymebt DUE DATE 0 <br /> If this INVOICE has been Paid, Please Oisregard this Notice <br /> i <br /> ' I <br /> Fir all SERVICE FEES penalties will <br /> Penalties will be added an all Percits addediiat the rate of ift 60 days ' <br /> at the rate of lift of the Base Fee 36 past Invoice date and each 31 days i <br /> days after the due date. thereafter. wt l <br /> TOTAL DUE this 8131ing Period: $23 . 40 <br /> Please ma7f G'hec cs PAYABLE . p!HS/:E.1#D t <br /> w�sw�i•rn•<."� <br /> AJG <br /> _ . � <br /> M d y{)AQUtN f.a uh(Y <br /> I I' PUBLIC HEALTH SERVICES <br /> ' "VIRONMENTAL HEALTH DIV&.GA 1, <br /> _1 z ! <br />
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