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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPA TMS - Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOC <br /> <br /> <br /> <br /> Date Printed 1/26/2007 <br /> FIELD TOWER SY TEMS (KS SOLUTI RE : FIELD TOWER SYSTEMS (KS SOLUTIONS) <br /> PO BOX 504 28135 E COPPEROPOLIS RD <br /> ELVERTA, CA 956 6 FARMINGTON, CA 95230 <br /> OWNER : FIELD, DAVID <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0158176---Date of Invoice: 125/2007 11111 1111 111111 11111 IE IN <br /> 1/25/2007 2220 SM HW G N<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZ AT FEE $ 270.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 500.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ ! 500.00 <br /> PEC�En <br /> R <br /> MAR p 6 2007 <br /> �OApU1N CpUNN <br /> SAN ��NMENTAL <br /> H��H pEPARTMENT <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 />