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SAN JOAQUIN COUNTY <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE AccountlD F AR0037302 <br /> CJ-/ LMMMMOMMOMMMA <br /> Facility ID FA0020783 <br /> Date Printed F 11/20/2012 <br /> LUIS VERA RE : CONSTRUCTION PROTECTIVE SERVICES <br /> CONSTRUCTION PROTECTIVE SERVICES 816 N SACRAMENTO ST <br /> 436 W WALNUT ST LODI, CA 95240 <br /> GARDENA, CA 90248 <br /> OWNER : COFFEY, CHRIS <br /> �atP Health <br /> Program Desuiipt;un Amcunt <br /> Invoice# IN0233729---Date of Invoice : „/19/2012 11111111111111 E 1111111111 111111111I 1111111111111111111111111111111111 1111/11111 <br /> 11/16/2012 4244 PUMPERTRUCK $ 158.00 <br /> 11/16/2012 4246 PUMPERYARD $ 110.00 <br /> 7,eln/ Total for this Invoice $ 268.00 <br /> d✓Y/' r 1 �y Payment Due Date 12/20/2012 <br /> TOTAL DUE this Billing Period $ 268.00 <br /> G , o <br /> ACL,4-1 t0��� <br /> - o <br /> 2U 2 DEC 0 3 2012 <br /> (,fes ENVIRpNM <br /> J ¢1� PERMIT/SERTN <br /> VICES <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 CES/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 /> 4 rPt <br />