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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0025024 <br /> Facility ID FA0014717 <br /> Date Printed 1/30/2012 <br /> EASTSIDE AUTO REPAIR RE : EASTSIDE AUTO REPAIR <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : EDMUNDO AYALA <br /> Date Health <br /> Program Description 1 I Amount <br /> Invoice# IN0224737---Date of Invoice; 1/30/2012 11111111111111111111 IN IN <br /> 1127/2012 2220 SM HW GEN c5 TONSIYR $ 213.00 <br /> 1127/2012 2244 2012 HAZMAT FEE $ 85.00 <br /> 1127/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 112712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> Total for this Invoice $ 347.00 <br /> Payment Due Date 2/29/2012 <br /> TOTAL DUE this Billing Periodl $ 347.00 <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 OES 1 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 />