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SAN ,),OAQUIN COUNTY �� AJ Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF <br /> 304 E WEBER AVE -3RD FLOOR <br /> STCr T N, CA <br /> <br /> CE AccountlD AR0016878 <br /> '0R 4�1 <br /> Facility ID FA0009878 <br /> Date Printed 1/30/2006 <br /> AG INDUSTRIAL MFG INC RE : AG INDUSTRIAL MFG INC <br /> PO BOX 53 110 S BECKMAN RD <br /> LODI, CA 95241 LODI, CA 95240 <br /> OWNER : AG INDUSTRIAL MFG INC <br /> Date Health Amount <br /> rogram Description <br /> Invoice IN0143761 -Date of Invoice: 1/27/2006 III'IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 1/27/2006 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 1/27/2006 2244 2006 HAZMAT FEE $ 360.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 434.00 <br /> Payment Due Date 3/ <br /> TOTAL DUE this Billing Period $ ,f34.0 <br /> vt D <br /> �EB <br /> SAN J 2 2 2006 <br /> it Vv' UTA,SOU <br /> H�CTy Ep�RTM�T Y <br /> (t" <br /> t� <br /> V- <br /> v� <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 />