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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTP"'NT Page 1 <br /> 600 E MAIN STREET ' <br /> S <br /> <br /> VOICE Account ID AR00179880 <br /> Facility ID FA0010980 <br /> Date Printed 1/28/2008 <br /> G&L BROCK CONSTRUCTION CO INC RE : G&L BROCK CONSTRUCTION CO INC <br /> 4145 CALLOWAY CT 4145 CALLOWAY CT <br /> STOCKTON, CA 95215-2400 STOCKTON, CA 95215-2420 <br /> OWNER : GARY& LYNNE BROCK <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0170612---Date of Invoice : 1/25/2008 1IIIIIE IIIIII 111 11111 11111 11111 11111 11111 11111 11111 11111 11111 IN 111111 11111 IN IN <br /> 1/25/2008 2220 SM HW GEN <5 TONS/YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 145.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoicel $ 382.00 <br /> Payment Due Date 2/27/2008 <br /> TOTAL DUE this Billing Period $ 382.00 <br /> PAYMENT <br /> RECEIVED <br /> MAR - 3 2008 <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 /> 5254.rpt <br />