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SAN JOAQUIN COUNTY r Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0016959 <br /> Facility ID FA0009959 <br /> Date Printed 2/5/2004 <br /> JUAN'S AUTO REPAIR RE : JUAN'S AUTO REPAIR <br /> 1145 S AURORA ST 1145 S AURORA ST <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : JUAN O MORGA <br /> Health Amount <br /> Date <br /> Program Description —------ ---- <br /> Invoice# IN0115851 ---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR S 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 300.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE S 24.00 <br /> Total for this Invoice $ 524.00 <br /> Payment Due Date 3/6/2 4 <br /> TOTAL DUE this Billing Period $ 524.00 <br /> 5�N �Q�M A- <br /> V�FtONp�,�MEtS <br /> H�ZH OE <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 /> 5255.rpt <br />