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ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600 E MAIN STREET ./ <br /> STOCKTON, 95202 COPY <br /> Phone:e: (209(209) 46 468-3420 <br /> INVOICE 1 3 3 ` Account ID F AR0025003 <br /> Facility ID FA0014696 <br /> Date Printed 3/31/2010 <br /> V&J ORNAMENTAL IRON WORKS RE : V&J ORNAMENTAL IRON WORKS <br /> 1201 N FILBERT ST 1201 N FILBERT ST <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : VICTOR RIVARN /JAIME SALAS <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0199284--Date ofInvoice: 2/2/2010 IIIIIIIIIIIIIIIIVIIIVIVIIVIIVIIVIIIVIIIIIIIIIIIIIIIIIIIIIII III <br /> 2/1/2010 2244 2010 HAZMAT FEE $ 285.00 <br /> 2/112010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 2/1/2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/20/2010 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> Total for this Invoice $ 362.50 <br /> Payment Due Date 3/4/2010 <br /> TOTAL DUE this Billing Period $ 362.50 <br /> �E?`.SE',t�tkE3C11. c:.€"l�fi.jOS <br /> Win iorwalcif <br /> In �G days. <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 DES/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 />