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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM' T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0001954 <br /> Facility ID FA0001946 <br /> Date Printed 1/30/2006 <br /> MATAR, MOHAMAD S RE : QUICK N SAVE* <br /> QUICK N SAVE* 1901 S EL DORADO ST <br /> 1901 S EL DORA60 ST STOCKTON, CA 95206 <br /> STOCKTON, CA 05206 <br /> OWER : MATAR, MOHAMAD S <br /> Date Health <br /> Program Descripti n Amount <br /> Invoice# IN0144273---Date of Invoice : 1/27/2006 I IIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII 11111 11111 IIII IIIIII IIIII 1111 1111 <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 H MAT FEE $ 100.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2301 UST STATE SURCHARGE FEE $ 15.00 <br /> 1/27/2006 2360 ADDITIONAL UST $ 125.00 <br /> 1/27/2006 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 979.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 979.00 <br /> SI <br /> i <br /> R, <br /> �FNt. <br /> Please make Checks P YABLE 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 />