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Account ID <br />Facility ID <br />Date Printed <br />AR0043023 I <br />FA0023362 <br />9/27/2019 <br />RE: DICKS SPORTING GOODS #1176 <br />5354 PACIFIC AVE <br />STOCKTON, CA 95207 <br />OWNER: DICKS SPORTING GOODS #1176 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Page 1 <br />INVOICE <br />ASHLEY CAMPBELL - ENV COMPLIANCE <br />DICKS SPORTING GOODS #1176 <br />5151 SAN FELIPE ST STE 1000 <br />HOUSTON, TX 77056 <br />Date Health <br />Program Description Amount <br />Invoice # IN0329863 --- Date of Invoice: 9/26/2019 <br /> <br />1111111 111111 111 1 111 1 11111 11111 11111 11111 1111 1 11111 11111 11111 1111 111111 11111 1 111 1111 <br />9/26/2019 <br /> <br />2220 SM HW GEN <5 TONSNR <br /> <br />$ 249.00 <br />9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br /> <br />$ 49.00 <br />Total for this Invoice 298.00 <br /> <br />Payment Due Date 10/27/2019 <br /> <br />[TOTAL DUE this Billing Periodi $ 298.00 <br /> <br />Please make Checks PAYABLE to: 'El-113 — 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% <br /> 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