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V01z0/G010 00:10 r 1.11 1. ."Oo <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART • Page 1 <br /> 500 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-420 fig'@ <br /> INVOICE I RECEI V®/ED..to AR0022209 <br /> AUG ® 2010 F.dnty to FA0013357 <br /> SAN JOAQUIN COUNA"te Primed 0/1912-010- <br /> OFFICE <br /> 2010OFFICE OF EMERGENCY SERVICES lummommommommum <br /> RUVALCABA,JUAN RE: CANCUN <br /> CANCUN 135 E MINER ST <br /> 135 E MINER ST STOCKTON,CA 95202 <br /> STOCKTON, CA 95202 <br /> OWNER: RUVALCAEIA,JUAN <br /> Date Health <br /> Program Description Amount <br /> Invoice 0 IN0201DQ—Date of ldwoice: 2=010 I�11I11119f 11111 IN M In 11110 11 oil 51111 <br /> 2/1/2010 2144 2010 HAZMAT FEE PLUS 5 YEARS BACK BILLING S 1,530.00 <br /> 2/12010 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE S 24.00 <br /> 21V2010 ERSC ELECTRONIC REPORTING SURCHARGE $ 25.00 <br /> 3/17/2010 9999 PAYMENT ($ 296.50) <br /> 427/2010 9999 PAYMENT ($ 295.00) <br /> 8/152010 9907 Hal Mat Program Penalty Fee $ 98.75 <br /> ram for Mlc lmroloe $ 1,088.25 <br /> PAST DUE <br /> TOTAL DUE this Billing Period S 1,086.25 <br /> Please make Checks PAYABLE to: 'EHD' - Rett a Copy of This STATEMENT vrnh Your PAYMENT <br /> Penalties will be added to all Permit Fees For DES I HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Perdties w01 be added at the Rate of 10% Penalties will be added at the Rate of 10 <br /> 30 Days after the Due Dale 45 Gays after the Invoice Date 60 Days after the Invoice Date and each 30 DayO thereafter <br /> 5254 rot <br />