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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEP4RTP IT Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0020269 <br /> Facility ID FA0012412 <br /> Date Printed 1/24/2005 <br /> DIVERSIFIED CONSTRUCTION SERVICES RE : DIVERSIFIED CONSTRUCTION SERVICES <br /> 5565 S EL DORAL O ST 5565 S EL DORADO ST <br /> FRENCH CAMP, CA 95231 FRENCH CAMP, CA 95231 <br /> OWNER : DIVERSIFIED CONSTRUCTION SERV <br /> Date Health <br /> Proaram Description Amount <br /> Invoice# IN0128464—Date of Invoice: 111/24/2005 IIIII IIIII 11111 11111 IN 111111 11111 IN IN <br /> 1/24/2005 2220 SM HW GEN 15 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 285.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 509.00 <br /> Payment Due Date 2/23/2005 <br /> TOTAL DUE this Billing Period $ 509.00 <br /> PAY M E N? <br /> RECEIVED <br /> FEB 2 3 2005 <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 I 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 />