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JAN JUAUUIN UUUN I T <br /> ENVIRONMENTAL HEALTH DEP RTMF"-- Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 952 <br /> <br /> OICE Account ID I r AR0016997 N <br /> Facility ID 7A0009997 <br /> LMUMMIMMMMMA <br /> Date Printed 1 1/26/2007 ' <br /> COUNTRY CLUB ERVICE RE : COUNTRY CLUB SERVICE <br /> 1403 W COUNTRY CLUB BLVD 1403 W COUNTRY CLUB BLVD <br /> STOCKTON, CA 9 204 STOCKTON, CA 95204 <br /> OWNER : GRIFFEN, STEPHEN <br /> Date Health <br /> Proqram Descriptio Amount <br /> Invoice# IN0156745---Date of Invoice : 1/25/2007 �1111 1111 111111 11111 IN IN <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 145.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 375.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 375.00 <br /> ENS <br /> F 1G G000 <br /> SP�NO R DW R��iNI <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 DES/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 />