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SITE INFORMATION AND CORRESPONDENCE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3000 – Underground Injection Control Program
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PR0515035
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
2/11/2019 3:56:26 PM
Creation date
2/11/2019 3:03:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
SITE INFORMATION AND CORRESPONDENCE
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 JOAOUIN COUNTY i4 I Page 1 i <br /> ENVIRONMENTAL HEALTH DEP 'HENT <br /> 301E WEBER AVE-3RD FLOOR <br />�. STOCKTON. CA 95202 <br />} Phone: 209468-3420 j <br />, I} <br /> INVOICE <br /># I Account ID AR0019074 <br /> IP Facility ID FA0012021 <br /> Date Printed' 8/27/2002 <br /> Da�e�rt <br /> I� <br /> RE : WESTERN SQUARE INDUSTRIES INC <br /> WESTERN SQUARE INDUSTRIES INC 1421 N BROADWAY AVE <br /> 1621 N BROADWAY AVE STOCKTON <br /> CA 95205 <br /> STOCKTON CA 95205 I} <br /> OWNER : WESTERN SQUARE INDUSTRIES INC <br /> !iP <br />} Health i t <br /> Date Program Description it Hrs Employee Amount <br /> Invoice# IN0097241 —Date of Invoice: 6/27/2002 <br /> 5/24/2002 3030 315 REPORT REVIEW 2.0 LAGOR10 $178.00 <br /> I} <br /> { Total for this Invoice $178.00 <br /> �{ Payment Due Date 7/28/2002 i <br /> TOTAL DUE this Billing Perlodl $178.00 <br /> Please make Checks PAYABLE to: EIID 1 Return a Copy of ThisISTATEMENT with Your PAYMENT <br /> _G <br /> Penalties will be added to all Permit Fees Ij For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee I;Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after;the Invoice Date and each 30 thereafter <br /> if <br /> Iz ' <br /> i� <br /> A <br /> I WE WOULD APPRECJrIJZ YOUR } <br /> PAYMENT TODAY! I' <br /> i� <br /> { <br /> I I:' <br /> r <br /> I <br /> Ill <br /> .i <br /> I <br /> i <br /> I <br /> II <br /> 5255.rpt <br /> ------•-- <br />
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