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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID (3)
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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K
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KOST
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10065
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4200 – Liquid Waste Program
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PR0538256
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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID (3)
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Entry Properties
Last modified
2/2/2023 2:48:41 PM
Creation date
3/11/2021 1:27:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
PR0538256
PE
4244
FACILITY_ID
FA0012769
FACILITY_NAME
SALVADOR GONZALEZ LABOR CONTRACTOR
STREET_NUMBER
10065
STREET_NAME
KOST
STREET_TYPE
RD
City
GALT
Zip
95632
CURRENT_STATUS
01
SITE_LOCATION
10065 KOST RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> •1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 p <br /> Phone: (209) 468-3420 C—an �o0 1 „ Oc Up6c4c-A `� c <br /> i il o �� i n A t.(�aji CA �5��2 -51APAccount ID AR0021369 <br /> LlV INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0012769 <br /> Date Printed 12/2/2021 <br /> SALVADOR GONZALEZ LABOR RE : SALVADOR GONZALEZ LABOR <br /> CONTRACTOR CONTRACTOR <br /> 217 FOURTH ST 10065 KOST RD <br /> GALT, CA 95632 GALT, CA 95632 <br /> OWNER : GONZALEZ, SALVADOR <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0361745---Date of Invoice: 10/26/2021 1111111 111111 111 INS IIIII 11111 11111 11111 HE 11111 11111 111111 IN IIIIII IIIII IIII IN <br /> 10/26/2021 4244 PUMPER TRUCK PRO541756 $ 184.00 <br /> 10/26/2021 4244 PUMPER TRUCK PR0538256 $ 184.00 <br /> 10/26/2021 4255 CHEMICALTOILETS PRO516745 $ 80.00 <br /> Total for this Invoice 1 $ 448.00 <br /> Payment Due Date 11/30/2021 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period $ 448.00 <br /> PAYMENT <br /> RECEIVED <br /> DEC 2 0 2021 <br /> SAN JOAQUIN COUNTY \` <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> V Would you like Invoices electronically or need to update the email address for this account? Fill out the <br /> form below with the information with up to 2 email addresses: <br /> Email 1 <br /> Email2 <br /> Please make Checks PAYABLE to: 'EHD'or <br /> Pay online at: 'https://www.smgov.org/department/envhealth/online-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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt End of report <br />
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