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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMr— Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> <br /> ccountlD AR00 88020 <br /> Facility ID FA0011020 <br /> Date Printed 2/5/2004 <br /> PEP BOYS #562 RE : PEP BOYS#562 <br /> 3111 W ALLEGHENY AVE 1401 S CHEROKEE LN <br /> PHILADELPHIA, PA 19132 LODI, CA 95240 <br /> OWNER : PEP BOYS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0116136---Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 345.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 569.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 569.00 <br /> PAYMENT <br /> FRECEIVED <br /> EB 2 3 2004 <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 /> 52».rpt <br />