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STATE WATER RESOURCES CONTROL BOARD <br /> INVOICE DETAILS <br /> INVOICE NO: 0514419 BILLING PERIOD: 07/01/05-06/30/06 FACILITY ID (WDID): 5B39NC00036 <br /> Ambient Pretreat! *Other **Fee <br /> Program Region 1 Annual Appl.: Appl: Appl.Months Credit <br /> Sur- <br /> Type Order No Fee Basis Fee Water Sur- .. Credit. Number bate Fee Credited Amount <br /> Monitor charge charge Amount <br /> NON15 5S/03-179 Threat/Compx. 2 B $5,720 $515 $0 $0 $0 46500 04-MAR-02 $1,200 0 $0 <br /> Invoice Totals by Charge: $5,720 $515 $0 .: $0.. $0 $0 <br /> INVOICE TOTAL: $6,235 <br /> it you nave any questions aoout this invoice, please call your Regional'Wa�er QuaKy 3ornroi Board ai (9i6)464-4734 <br /> *Other Surcharge: <br /> SUB15 with water quality threat and complexity(1 A)is$12,000. <br /> NPDES with water quality threat and complexity(1 A)is$15,000. <br /> NPDES with water quality threat and complexity(1 B)is$10,000. <br /> NPDES with water quality threat and complexity(1 C)is$5,000. <br /> **SWRCB IS PROVIDING a one-time fee credit in the NPDES storm water and <br /> WDR Land Disposal fee schedules for the 2005/06 fiscal year to conform to the <br /> revenue levels set forth in the Budget Act. <br /> _.. <br /> ...... .............................................................................................--..........................._....................._..............--__..._..................._.........._..._._..... <br /> BILLING ADDRESS CORRECTIONS <br /> Please print the new billing address information in the space provided below <br /> .—_tic,—i • iG+G��: ^.:.—�iv3��v�ri�v:l viA.:i TE� TrA VI VIP <br /> �:vri <br /> BILLINGNAME: � 11 Mil 1111 ITT � 11111L] <br /> CONTACT PERSON: <br /> STREET: <br /> CITY: <br /> STATE: m <br /> ZIP: <br /> PHONE: ( ) -F FT7 REGION 5S <br />