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�l <br /> SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMr - <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE <br /> <br /> /2004 <br /> GB INDUSTRIAL SPRAY INC RE : GB INDUSTRIAL SPRAY INC <br /> 1140 BESSEMER AVE#1 1140 BESSEMER AVE 1 <br /> MANTECA, CA 95337-6118 MANTECA, CA 95337 <br /> OWNER : GARY BEAUCHAMP <br /> Health <br /> Date P.ogmrn Deacriotion Amount <br /> Invoice# IN0115862—Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 360.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 584.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 584.00 <br /> RECEIVED <br /> LIAR 19, 2004 <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 /> 5255.rpt <br />