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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART JT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0000109 <br /> Facility ID FA0000110 <br /> Date Printed 6/1/2007 <br /> EUGENIA D VALDEZ RE : J & L MARKET <br /> J & L MARKET 8115 S EL DORADO ST <br /> PO BOX 238 FRENCH CAMP, CA 95231 <br /> FRENCH CAMP, CA 95231 <br /> OWNER : VALDEZ, EUGENIA DUARTE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0163574—Date of Invoice: 611/2007 11111 11111 1111 111111 11111 IN IIII <br /> 6/1/2007 2220 SM HW GEN<5 TONSNR $ 206.00 <br /> Total for this Invoice $ 206.00 <br /> Payment Due Date 7/1/2007 <br /> TOTAL DUE this Billing Period $ 206.00 <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 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% 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 />