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. . ....... ... <br /> E MAIN STREET <br /> OCKTON, 46 95202 COPY <br /> Phone: (209) 468-3420 <br /> INVOICE n��— RECEIVE® <br /> Amount to ARoo1 sols <br /> 2 i lummmummmomill <br /> FacilirylD FA0009079 <br /> JL 1 u <br /> '- ir <br /> SAN JOAOUIN COUNTY Date Printed F 5126/2011 <br /> OFFICE OF EMERGENCY SERVICES <br /> ABC RADIATOR RE : ABC RADIATOR <br /> 601 S WILSON WAY 601 S WILSON WAY <br /> STOCKTON, CA 95205 STOCKTON, CA 95205 <br /> OWNER : EDWARD F FORTUNE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0210670---Date of Invoice: 1/31/2011 111111111111111 IN 111111111111111 IN 1111111111111111111 <br /> 1/28/2011 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/28/2011 2244 2011 HAZMAT FEE $ 330.00 <br /> 1/28/2011 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> 1/28/2011 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE $ 25.00 <br /> 3/20/2011 9987 Haz Mat Program Penalty Fee $ 33.00 <br /> 4/15/2011 9994 PERMIT FEE PENALTY $ 213.00 <br /> Total for this invoice $ 838.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 838.00 <br /> unt ^1u� <br /> Wiii be <br /> 30f FS..4 t�t�! <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 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.rp1 <br />