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SAN;JOAQUJN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0048476 <br /> INVOICE <br /> Facility 1D FA0025656 <br /> Date Printed 12/19/2019 <br /> BSC ESPRESS TRUCK & TRAILER REPAIR RE : BSC ESPRESS TRUCK&TRAILER REPAIR <br /> 1850 PARK ST 1850 PARK ST <br /> LATHROP, CA 95330 LATHROP, CA 95330 <br /> OWNER : BSC EXPRESS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0332984---Date of Invoice: 12/19/2019 11111111 E111 h 11111 11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 111 1111 IN <br /> 12/19/2019 1920 HMBP-Common Materials S 115.00 <br /> 12/19/2019 1922 CERS Processing Fee S 30.00 <br /> 12/19/2019 2220 SM HW GEN<5 TONSNR $ 249.00 <br /> 12/19/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 443.00 <br /> Payment Due Date 1/18/2020 <br /> TOTAL DUE this Billing Period $ 443.00 <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 />