Laserfiche WebLink
CR0 # TO: 0FICE OF REVENUE AND RECOVERY • <br /> ACCOUNT TRANSMITTAL 0 <br /> ACCOUNT NO. DEPT.NO. REFERRAL t�LJf� �1111( <br /> 026000.0 nATF C <br /> LAST - GUARANTOR - FIRST MI TITLE LAST - AKA - FIRST MI TITLE <br /> GOLDEN GATE ORN IRON WORKS <br /> C/O NAME GUARANTOR SSN <br /> JESUS T VALENZUELA <br /> MAILING STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 2489 E MINER AVE STOCKTON CA 95205 209-941-4090 <br /> RESIDENCE STREET CITY ST ZIP CODE AREA PHONE NO. <br /> 209-941-4090 <br /> USER REFERENCE NO. I BILL STAI CYCLE STATUS DATE BMI CBMC INT I MONTHLY PAY AMT IP"' TERM DATEIF QATF <br /> 6139 HAZMAT 3/15/08 <br /> CHARGES <br /> LAST - RECIPIENT - FIRST MI TITLE RECIPIENT USER REFERENCE NO/NARRATIVE <br /> nnRSERVICE DATE: DATE OF <br /> START STOP MED REC NO CHARGE <br /> CHARGE DEPT.NO. DESCRIPTION AMOUNT CHARGE DEPT.NO. DESCRIPTION AMOUNT <br /> NONo <br /> 230 026000.0 2008 Hmmp Annual Fee $240.00 <br /> 3 Chems @ $15.00 Each $45.00 <br /> 10% Late Charge $28.50 <br /> State Surcharge Fee $24.00 <br /> Sm Hw Gen <5tons/yr $213.00 <br /> Permit Fee Penalty $213.00 <br /> TOTAL $763.50 <br /> GUARANTOR <br /> DOB DR LIC NO AUTO LIC NO <br /> PRIOR STREET CITY ST ZIP CODE <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GOLDEN GATE ORN IRON WORKS 209-941-4090 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2489 E MINER AVE STOCKTON CA 95205 <br /> afeBSE* CO-OWNER <br /> LAST FIRST MI TITLE SOC SEC NO. DOB DR LIC NO AUTO LIC NO <br /> VALENZUELA MANUELA <br /> EMPLOYER NAME EMPLOYER PHONE NO <br /> GOLDEN GATE ORN IRON WORKS 209-941-4090 <br /> EMPLOYER STREET CITY ST ZIP CODE <br /> 2489 E MINER AVE STOCKTON CA 95205 <br /> PREPARED BYG CHECKED BY � � DATE ,1/® yI COL. 20 088 <br />