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S,4N JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTM-,,jT <br />600 E MAIN STREET <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />,-ENV-RRGMS/BOXC 17- <br />CALIF NATL GUARD / COMBINED SUPPLY <br />9800-- GO -E T'H E -RD <br />-SAC4?.W&NT0, GA --95 27-3563 — <br />1 C�' 1r"2c) y- �k- <br />Page 1 <br />Account ID AR0009076 <br />Facility ID FA0006696� <br />Date Printed 1/30/2012 <br />RE: CALIF NATL GUARD/ COMBINED SUPPLY <br />8020 S AIRPORT WAY <br />STOCKTON, CA 95206 <br />OWNER: CALIFORNIA ARMY NATIONAL GUARD <br />Date Health <br />Program Deccrintion Amount <br />Invoice # IN0223060 --- 0 to of Invoice : 1/30/2012 <br />1/27/2012 <br />2244 2012 HAZMAT FEE <br />1/27/2012 <br />2247 RCRA GEN 5<25 TONS <br />1/27/2012 <br />2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />1/27/2012 <br />ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE <br />I <br />II (IIII IIIIII III VIII VIII III II VIII VIII VIII VIII VIII VIII VIII IIII <br />$ <br />IIIIII VIII IIII II II <br />480.00 <br />$ <br />1,672.00 <br />$ <br />24.00 <br />$ <br />25.00 <br />Total for this Invoice $ 2,201.00 <br />Payment Due Date 2/29/2012 <br />TOTAL DUE this Billing Period $ 2,201.00 <br />PAYMENT <br />RECEIVED <br />FEB 21 2012 <br />SAN JOAQUIN COUNTY <br />ENVIROMENTAL <br />HEALTH DEPARTMENT <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />'enalties 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 thereaftc <br />5_'>-4 rpt <br />