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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTP VT Page 1 <br /> 600 E MAIN STREET ` <br /> <br /> <br /> ICE __ _ 1 -__ __- <br /> Account ID AR0017086 <br /> Facility ID FA0010086 <br /> Date Printed 1 1/28/2008 <br /> BARLEEN, DAVID G RE : MOTOR GUARD CORP <br /> MOTOR GUARD CORP 580 CARNEGIE ST <br /> 580 CARNEGIE ST MANTECA, CA 95337 <br /> MANTECA, CA 95337-6141 <br /> OWNER : MOTOR GUARD CORP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170406---Date of Invoice: 1/25/2008 1111111 1111 h 11$11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 1111�1111 IN <br /> 1/25/2008 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 285.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 522.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 522.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 2 20w <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 /> �'?i4.rpt <br />