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SAN JOAQU4N COUNTY <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICERCOPY Account lD �AR0037070 <br /> Facility ID FA0020673 <br /> Date Printed 11/20/2014 <br /> CHAVEZ, JOSE C RE : KALIFORNIA GOLD AG SERVICES <br /> KALIFORNIA GOLD AG SERVICES 28777 AVENUE 13 <br /> 28777 AVENUE 13 MADERA, CA 93638 <br /> MADERA, CA 93638 <br /> OWNER : CHAVEZ, JOSE C <br /> Huaiih <br /> Date Program Description Amount <br /> Invoice# IN0257989---Date of Invoice: 11/19/2014 II�IIIIIIII'I�IIIIIIIIIII IIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIIIIIIIII <br /> 11/19/2014 4244 PUMPER TRUCK $ 158.00 <br /> Total for thisInvoice $ 158.00 <br /> Payment Due Date 12/20/2014 <br /> TOTAL DUE this Billing Period $ 158.00 <br /> III&A Cclm�)al�y ' <br /> R <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.il)t <br />