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SAN jOAQWN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON,,CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0016146 <br /> INVOICE <br /> ' Facility ID FA0009146 <br /> _,.___._ Date•P.rinted 9/27/2019 <br /> p , <br /> • LYONS, NATHANIEL �/ / BUGS COLLISION <br /> BUGS COLLISION f v� 1251 E BIANCHI RD <br /> X 87 STOCKTON, CA 95210-352 r <br /> STOC 95208 <br /> �N(ER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0326991 ---Date of Invoice: 9/26/2019 1111 111111 11111 1111 IN <br /> 9/26/2019 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 298.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 298.00 <br /> PAYMENT <br /> RECEIVED <br /> OCT 15 2019 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' — 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% 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 <br />