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SAN JOAQUIN COUNTY <br /> ENVIREINMENTAL HEALTH DEPARTN--'T Page 1 <br /> ;04 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA <br /> <br /> AR0016373 <br /> Facility ID FA0009373 <br /> Date Printed 2/24/2005 <br /> CARNEGIE SVRA RE : CARNEGIE SVRA <br /> 13300 WHITE ROCK 18600 CORRAL HOLLOW RD <br /> RANCHO CORDO A, CA 95742 TRACY, CA 95377 <br /> OWNER : STATE OF CALIFORNIA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0129089---Date of Invoice: 1/24/2005 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 1/24/2005 2220 SM HW C EN<5 TONSNR $ 200.00 <br /> 1/24/2005 2244 2005 HA2 MAT FEE $ 360.00 <br /> 1/24/2005 2399 UNIFIED DROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 584.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 584.00 <br /> SAN JOAQUm COUNTY <br /> Et WV ONMENTAI. <br /> H�LTo DEPAFTMENT <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 IDES/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 /> i2ji.rpt <br />