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BILLING_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231345
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BILLING_PRE 2019
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Entry Properties
Last modified
9/1/2021 1:00:51 PM
Creation date
10/11/2018 2:24:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0231345
PE
2381
FACILITY_ID
FA0003713
FACILITY_NAME
CHEVRON #95775 MCCOMBS* (INACT)
STREET_NUMBER
301
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04514002
CURRENT_STATUS
02
SITE_LOCATION
301 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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KBlackwell
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EHD - Public
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5AN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRQVMENTAL HEALTH DIVI, N <br />3�'4 E WEBER AVENUE — 3RD F_✓OR <br />PO 60X 388 <br />STOCKTON, CA 95201-0388 <br />Accounting Office: 209 468-3420 <br />.M . Y'...1 4%.J' Co .1. C:;: e:t <br />TO: CHEVRON USA <br /> <br /> <br />ATTNa KATHY NORRIS/PERMIT DESK <br />RE: CHEVRON #95715 MCCOMBS <br />301' W -KETTLEM-AN L4- LODI- <br />Report 15255 <br />Sta 'nent Printed: 1.2/18/96 <br />PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br />Account #� 03292 <br />Facility ID 003713 <br />Service Activity <br />Date Description Hrs Employee Amount <br />Invoice # 034490 -- Date of Invoice: <br />12/17/96 2380 UST Permit Fee <br />12/17/96 2380 UST Permit Fee <br />12/17/96 2380 UST Permit Fee <br />12/17j96 2380 UST Permit Fee <br />If this INVOICE has been Paid, Please Disregard this Notice . . . <br />12/17/96 <br />Tank <br /># TA134504 <br />$170.04 <br />Tank <br /># TA134501 <br />$170.00 <br />Tank <br /># TA134502 <br />$170.00 <br />Tank <br /># TA134503 <br />Total for <br />this invoice:$680.00 <br />Payment <br />DUE DATE <br />01/18/9 <br />MENT <br />JAN 3 01997 <br />g% %6.500 ,D(/ 7 7. �SArd JOA()UirqOUiv r <br />PUBLIC HEALTH SERVICES <br />lJ „ „l1 r1wd �I �j� nQ ENV'RONM NTAL HEALTH DIV!SiOr, <br />Com/ L(.c0� ( ( 1 '17 <br />PENALTIES for all FEES for SER E will be ASSESSED <br />PENALTIES will be ASSESSED on all ANNUAL PERMIT Fe at the rate of 104 of the Service Fee <br />at the rate of 1008 of the Base Fee 30 days after the Payment DUE DATE <br />30 days after the Payment DUE DATE. and EACH 30 days thereafter. <br />TOTAL DUE this Billing Period: $680.00 <br />Please Make CHECKS PAYABLE to: 0c1 D --II q:::::: R II If.::1i <br />0 to 30 days 31 to 60 days 61 to 90 days <br />Balance <br />d <br />91 to 110 days ) 120 days Account <br />l <br />
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