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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0004255 <br /> <br /> <br /> <br /> TIKI LAGUN PARTNERS LLC RE : TIKI LAGUN RESORT 8r MARINA <br /> TIKI LAGUN RESORT & MARINA 12988 W MCDONALD RD <br /> 3461 BROOKSIDE RD STE C STOCKTON, CA 95206 <br /> STOCKTON, CA 95219 <br /> OWNER : TIKI LAGUN PARTNERS LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0334965---Date of Invoice: 3/9/2020 11111111111111 E 11111 IHI 111�1 11111 11111 11111 1111�11111 11111 IN 11EI 1EI 1111111 <br /> 3/9/2020 1921 HMBP-Regular-Primary Location $ 364.00 <br /> 3/9/2020 1922 CERS Processing Fee $ 30.00 <br /> 3/9/2020 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 3/9/2020 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> 3/9/2020 APSA APSA SURCHARGE $ 26.00 <br /> Total for this Invoice $ 718.00 <br /> Payment Due Date 4/8/2020 <br /> TOTAL DUE this Billing Period $ 718.00 <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 HMBP 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 wall be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> i2i4.rpt <br />