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--- - -- ----- -----. . Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET • • <br /> STOCKTON, CA 95202 <br /> Phone:-(209) 468-3420 <br /> INVOICE Account ID AR0016986 <br /> Facility ID FA0009986 <br /> Date Pnmed 5/27/2009 <br /> GOLDEN GATE ORN IRON WORKS RE : GOLDEN GATE ORN IRON WORKS <br /> 2489 E MINER AVE 2489 E MINER AVE <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : VALENZUELA, JESUS T <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0184590---Date of Invoice: 1/29/2009 IIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIII IIIII IIIIIIIIIIIIIIIIIIIIII1I IIIIIIIIIIIIIIIIN <br /> 1/29/2009 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/29/2009 2244 2009 HAZMAT FEE $ 285.00 <br /> 1/29/2009 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2009 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2009 9994 PERMIT FEE PENALTY $ 213.00 <br /> To for this Invoice $ 763.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 763.50 <br /> �t�as r <br /> to <br /> Ift �� f�dt1S <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 OES/HMMP Fees For all SERVICE FEES <br /> at the Rate of 1D0%,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 />