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JAN JUAUUIN GUUN I T <br /> ENVIRONMENTAL HEALTH DEPARTMF"— Page 1 <br /> 304 E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0001954 <br /> Facility ID FA0001946 <br /> Date Printed 1/26/2007 <br /> MATAR, MOHAMAD S RE : QUICK N SAVE* <br /> QUICK N SAVE* 1901 S EL DORADO ST <br /> 1901 S EL DORADST STOCKTON, CA 95206 <br /> STOCKTON, CA 9 206 <br /> OWNER : MATAR, MOHAMAD S <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0158082---Date of Invoice : 125/2007 1MIT IIIIII 111 11111 11111 11111 1111�RE IIIII IIIII IIIII 11T IIII 11111�11111 IN 1111 <br /> 1/25/2007 2220 SM HW G N<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZ AT FEE S 100.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/25/2007 2360 ADDITIONAL UST $ 125.00 <br /> 1/25/2007 2362 UST FACIL,TY& 1 TANK $ 500.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 985.00 <br /> Payment Due Date 2/ <br /> TOTAL DUE this Billing Period $ 985.00 <br /> PAYMIVE� <br /> FiECE- <br /> FEB 12 2007 <br /> Sm JOAOUIN COUNTY <br /> FNVIRONMEKTAL <br /> HEATH DEPARTMENT <br /> Please make Checks PAY BLE to: 'EHD' - Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will be added to all Permit Fees For OES/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 /> 5254.rpt <br /> I <br />