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.................. ............... ..................... <br /> SAN J(JAQUIN GULINTY Page 1 <br /> .,ENVIRONMENTAL HEALTH DEPARTMA <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE Copy 9Account ID AR0025024 <br /> Facility ID FA0014717 <br /> Date Printed 5/30/2012 <br /> EASTSIDE AUTO REPAIR RE - EASTSIDE AUTO REPAIR <br /> <br /> STOCKTON, CA 95216 <br /> OWNER - EDMUNDO AYALA <br /> Date Health Program Description Amount <br /> Invoice# IN0224737---Date of Invoice: 113012012 <br /> 1/27/2012 2220 SM HW GEN<5 TONSfYR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 85.00 <br /> 1127/2012 2399 UNIFIED PROGRAM FAG STATE SURCHARGE FEE $ 24.00 <br /> 1/2712012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25,00 <br /> 3115/2012 9987 Haz Mat Program Penalty Fee $ 8.50 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for $ 5138.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 563.50 <br /> P , 6103i' D U E <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <br /> in 3-0 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 OES I HMMP Fees For all SERVICE FEES <br /> at the Rate of 100%of the Base Fee Pen alti eswil.l.,4!?,.Ado!ad.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 />