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0 RECIVED <br /> SAN JOAQUIN COUNTY JAN 3 U 2W8 <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 600E MAIN STREET Q�CE OFEMBE JUAUUIN I OUNIY <br /> STOCKTON, CA 95202 EMER®ENOYBERVIDE3 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0027921 <br /> Facility ID 1—FA0016007 <br /> Date Printed <br /> PARSON, CASEY RE : CASEY'S GIANT TIRE <br /> CASEY'S GIANT TIRE 1215 WATERLOO RD <br /> 1108 W TURNER RD STOCKTON,CA 95205 <br /> LODI,CA 95242 <br /> OWNER: PARSONS,CASEY <br /> Date Health <br /> Program Description Amount <br /> Invoice 0 IN0173249—Date of Invoice: 112512008 I NIIII�IIIIY�IMillllllflll�tlY�INlllllfll�lt�IIiIIIINNi�l�ll <br /> 1/25/2008 2244 2008 HAZMAT FEE $ 315.00 <br /> 1125/2008 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this tnvoioe $ 339.00 <br /> Payment Due Date 2/2712008 <br /> TOTAL DUE this Billing Period $ 339.00 <br /> Please make Checks PAYABLE to: 'EHE' - 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 10V/.of the Base Fee Penalties wilt be added at the Rate of 10% Penalties will be added at the Rate of 1WI. <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 /> 2 'd EZ69-69E-60Z 4,4na d9Z :b0 80 06 Uer <br />