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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID (6)
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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R
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ROSCOE
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201
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4200 – Liquid Waste Program
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PR0507143
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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID (6)
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Entry Properties
Last modified
2/2/2023 2:49:59 PM
Creation date
2/9/2022 2:44:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
PR0507143
PE
4244
FACILITY_ID
FA0000620
FACILITY_NAME
UNITED SITE SERVICES
STREET_NUMBER
201
STREET_NAME
ROSCOE
STREET_TYPE
RD
City
MODESTO
Zip
953571828
CURRENT_STATUS
02
SITE_LOCATION
201 ROSCOE RD
P_LOCATION
98
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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SAN JOAQUIN COUNTY <br /> ENVIRONMENi'AL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> 'STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0000619 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0000620 <br /> Date Printed 12/2/2021 <br /> wlca wu�mcanvzu�zrati�c�ir�,� <br /> KING, MIKE - RE : ABS A PORTABLES INC <br /> A&-A PORTABLES fN*r NI'� (Wt � j s ,uCs. 201 ROSCOE RD <br /> 201 ROSCOEC RD C�Ia�1 QUA MODESTO, CA 95357-1828 <br /> MODESTO, CA 95357 C (� I 1 <br /> J <br /> OWNER : KING, MIKE <br /> Health <br /> Date Program Description <br /> Amount <br /> Invoice# IN0361736 ---Date of Invoice: 10126/2021 IIIIIIIIIIIIIIIIIIIII)IIIII IIIIIIIIIIIIIIIIIIIIIIIII IIDII 1111111 IN <br /> 10/26/2021 4244 PUMPER TRUCK PR0542491 $ 184.00 <br /> 10/26/2021 4244 PUMPER TRUCK PRO540666 $ 184.00 <br /> 10/26/2021 4244 PUMPER TRUCK PR0420132 $ 184.00 <br /> 10/26/2021 4244 PUMPER TRUCK PRO507142 $ 184.00 <br /> 10/26/2021 4244 PUMPER TRUCK PR0507143 $ 184.00 <br /> 10/26/2021 4244 PUMPER TRUCK PRO518141 $ 184.00 <br /> 10!26/2021 4244 PUMPER TRUCK PR0526608 $ 184.00 <br /> 10/26/2021 4255 CHEMICAL TOILETS PR0420092 $ 2,400.00 <br /> Total for this Invoke $ 3,688.00 <br /> Payment Due Date 11/30/2021 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period $ 3,688.00 <br /> PAYMENT <br /> RECEIVED <br /> JAN 0 4 2022 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> 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 /> Email 2 <br /> Please make Checks PAYABLE to: 'EHD' or <br /> Pay online at: 'hatl�s;lf�vwvt.sov.e7rc/eie?, rlr�e�tlr.nui2e tlthfc�e7tire-p }rY,Er,t' <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 /> 5154 mt End of rcoon <br />
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