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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTM f <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR 0021027 <br /> INVOICE <br /> Facility ID FA0012670 <br /> Date Printed r 4/20/2015 <br /> L <br /> MANAGEMENT SERVICES RE : CENTRAL SERVICES <br /> 7000 MICHAEL N CANLIS BL 7000 MICHAEL N CANLIS BLVD <br /> FRENCH CAMP, CA 95231-9781 FRENCH CAMP, CA 95231 <br /> OWNER : SAN JOAQUIN CO <br /> Date Health <br /> Program Description Amount <br /> Invoice# ING265394---Date of Invoice: 4/20/2015 (IIIIII IIIIII IIIVIIIVIIIVIII VIII VIII VIIIVIII VIIIVIII(III IIIIII VIII(III IN <br /> 4/20/2015 1921 HMBP-Regular-Primary Location $ 375.00 <br /> 4/20/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 410.00 <br /> Payment Due Date 5/20/2015 <br /> TOTAL DUE this Billing Period $ 410.00 <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> _>4,ri <br />