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--------------- <br /> 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 Account LOMOMMMMMMOM <br /> AR0016097 <br /> Facility ID FA0009097 <br /> Date Printed 1/30/2012 <br /> 111111111110, <br /> CRONIN, BILL RE : BIG O TIRES#31 <br /> BIG O TIRES#31 810 E YOSEMITE AVE <br /> 810 E YOSEMITE AVE MANTECA, CA 95336 <br /> MANTECA, CA 95336 <br /> OWNER : CRONIN, BILL/CHRISTENSEN, E <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0223171 ---Date of invoice: 1/3012012 IIIIIIII 111111 IIIIIIII IIIIIIIIII III VIII I�III I�IIIIIIIIIIIIIII�I IIIIIIII III <br /> $ 213.00 <br /> 1/2712012 2220 SM HW GEN c5 TONS/YR $ 85.00 <br /> 1/27/2012 2244 2012 HAZMAT FEE $ 24.00 <br /> 1/2712012 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 25.00 <br /> 1/27/2012 ERSC ELECTRONIC REPORTING STATE SURCHARGE FEE <br /> Total for this Invoice $ 347.00 <br /> Payment Due Date 212 912 01 2 <br /> TOTAL DUE this Billing Period $ 347.00 <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> fat <br /> nalties will be added to all Permit Fees For DES/HMMP Fees penalties will be added at the Rate of I <br /> the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% 60 Das after the Invoice Date and each 30 Daafter <br /> 30 Days after the Due Date 45 Days after the Invoice Date Y <br /> 5254 rpt <br />