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JAN JUHUIUIN UUUN I T Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMF46 <br /> 600 L MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account 10 AR0016986 <br /> `Q \� Facility ID FA0009986 <br /> Date Printed F 5/28/2008 <br /> GOLDEN GATE ORN IRON WORKS RE : GOLDEN GATE ORN IRONWORKS <br /> 2489 E MINER AVE 2489 E MINER AVE <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : VALENZUELA, JESUS T <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0170704...Date of Invoice: 1125/2008 IIIIIIIIIiI IIIVIVIIIVIIIIIIIIIIVIVI VIIIVIIIIIIIIIIIIVIIIIIIII <br /> 1/25/2008 2220 SM HW GEN<5 TONS(YR $ 213.00 <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 285.00 <br /> 1/25/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 3/15/2008 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2008 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this Invoice $ 763.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 763.50 <br /> ,oA <br /> [)eiinauent charges <br /> wiii br: lorwarded to <br /> COLLECTIONS <br /> in 50 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 />