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JAN JUAUIUIN L;UUN I Y Page 1 <br /> 'ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICEAccountID AR0015291 <br /> FacilitylD FA0009291 <br /> Date Printed 5/30/2012 <br /> TEDS WELDING & REPAIR RE : TEDS WELDING & REPAIR, <br /> PO BOX 726 8932 E HWY 12 <br /> VICTOR, CA 95253 VICTOR, CA 95253 <br /> OWNER : G WILLIAM BRAUN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0223246--Date of Invoice: 1/30/2012 IIIIIIIIIIIIIIIIIIIIIIVIIIVIIVIII VIII VIIIIIIIVIIIIIIIIIIIIIIIIIIIIII <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 285.00 <br /> 1/27/2012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/15/2012 9987 Haz Mat Program Penalty Fee $ 28.50 <br /> 4/15/2012 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total forthis Invois!J $ 788.50 <br /> PAST DUE <br /> TOTAL DUE thisBilling Period $ 788.50 <br /> PAST D�J E <br /> Delinquent charges <br /> will be forwarded to <br /> ( OLLECT11ONS <br /> in 30 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/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% Ranalt;es,wil I 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 />