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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Amount ID ARO0 55616 <br /> Facility ID FA0019937 <br /> Date Printed F 3/28/2012 <br /> REYNOSO, FRANK RE : IMPERIAL AUTO SPA <br /> IMPERIAL AUTO SPA 1211 S TURNPIKE RD <br /> 1101 S CENTER ST STOCKTON, CA 95206 <br /> STOCKTON, CA 95206-1327 <br /> OWNER : REYNOSO, FRANK <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0222427---Date of Invoice: 12/28/2011 IIIIIIIIIIIIIIIIII I1I11III11IIVIIIVIIIVIII VIII IIII 11111111111 IIII IIII <br /> Hrs Employee <br /> 11/9/2011 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.50 RIVERA $ 62.50 <br /> 3/15/2012 9988 SERVICE CHARGE PENALTY $ 6.25 <br /> Total for this Invoice $ 68.75 <br /> PAST DUE <br /> Invoice# IN0226232---Date of Invoice: 1/30/2012 I1111111Ililllllllllll llllllllll11111llllllllll11111111111111111111111111111111111111 <br /> 1/27/2012 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 100.00 <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 $ 10.00 <br /> Total For this Invoice $ 372.00 <br /> Payment Due Date 2/29/2012 <br /> TOTAL DUE thisBilling Period $ 440.75 <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 Data 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254 rpt <br />