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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTP -`IT Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 4 <br /> ntlD AR0003913 <br /> Facility ID FA0004231 <br /> Date Printed 2/25/2005 <br /> J M MFG CO INC RE : J-M MANUFACTURING CO INC <br /> 9 PEACH TREE HILL RD 1051 SPERRY RD <br /> LIVINGSTON, NJ 07039 STOCKTON, CA 95206 <br /> OWNER : J M MANUFACTURING CO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0129294---Date of Invoice : 1/24/2005 1111 11111 11111 11111 IIE 11111 1111 111111 11111 IN IN <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 480.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24-M-) <br /> Total for this Invoice $ 704.00 <br /> Payment Due Date 2/23/20 <br /> TOTAL DUE this Billing Period $ 704.00 <br /> PAYMEN]_ <br /> RECEIVED <br /> FEB 2 8 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 /> S?Si.rht <br />