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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMr--_r <br /> 304E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0003412 <br /> Facility ID FA0003824 <br /> Date Printed 3/15/2004 <br /> UNIVERSAL FOREST PROD INC RE : UNIVERSAL FOREST PROD INC <br /> 2801 E BELTLINE 4554 S EL DORADO ST <br /> GRAND RAPIDS, MI 49525 STOCKTON, CA 95206 <br /> OWNER : UNIVERSAL COMPANY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0115800---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 $ 330.00 <br /> 2/4/2004 2301 UST STATE SURCHARGE $ 15.00 <br /> 2/4/2004 2362 UST FACILITY&1 TANK $ 500.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> 3/15/2004 9997 CORRECTION TO A CHARGE ($ 15.00) <br /> 3/15/2004 9997 CORRECTION TO A CHARGE ($ 500.00) <br /> Total for this Invoice $ 554.00 <br /> Payment Due Date 3/6/2004 <br /> TOTAL DUE this Billing Period $ 554.00 <br /> P�CEj J D <br /> R <br /> MAK 15 2Cr� <br /> SAN JOAQUIM N AL11 <br /> HTB 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 /> 5255.rpt <br />