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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> atOAR' Q COPY Account ID AR0017532 <br /> Irn �� 1NVOIC <br /> Facility ID FA0010532 <br /> Date Printed 12/31/2019 <br /> 03�P <br /> GIGLI, JOE RE : GIGLI CO INC <br /> GIGLICO INC 1\441 TEeA J CA q!5 3310 12333 S MANTHEY RD BOX C <br /> LATHROP, CA 95330 <br /> OWNER : GIGLICO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0327536---Date of Invoice: 9/26/2019 11111111 111111 III VIII VIII VIII VIII VIII VIII VIII VIII VIII 1111111111 <br /> VIII IIII IIII <br /> 9/26/2019 1921 HMBP-Regular-Primary Location $ 449.00 <br /> 9/26/2019 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2019 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> 9/26/2019 2832 AST FAC 10 K-</=100 K GAL CUMULATIVE $ 743.00 <br /> 9/26/2019 APSA APSA SURCHARGE $ 26.00 <br /> 12/15/2019 9987 Haz Mat Program Penalty Fee $ 44.90 <br /> 12/15/2019 9994 PERMIT FEE PENALTY $ 249.00 <br /> 12/15/2019 9997 CORRECTION TO A CHARGE ($ 743.00) <br /> Total for this Invoice $ p <br /> PAST DUE <br /> TOTAL DUE this Billing Period 1,096.90 <br /> PAST <br /> WEr1,'1LsD A0"'�IrCtATE Y OUR <br /> W �. <br /> PA�+`N'irNT TODAY! <br /> G�(Qr s PAYMENT RECEIVED <br /> C°rYezh',�YL JAN 13 2020 <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 HMBP 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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />