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.JOAQUIN COUNTY PUBLIC HEALTH SERVICES Page 1 <br /> WIRONMENTAL HEALTH DIVIS <br /> J4 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account I AR0003362 <br /> LMMOMMMMMMJ <br /> Facility I FA000211 <br /> Date Print 4/24/00 <br /> BENJAMIN HOLT SHELL RE: SHELL SERVICE STA* <br /> SHELL SERVICE STA* 3011 W BENJAMIN HOLT DR <br /> 3011 W BENJAMIN HOLT DR STOCKTON CA 95207 <br /> STOCKTON CA 95207 <br /> OWNER: EQUILON LLC ENTERPRISES <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0069365—Date of Invoice: 4/19/00 <br /> 4/19/2000 2220 SM HW GEN<5 TONSNR $100.00 <br /> 4/19/2000 2301 UST STATE SURCHARGE $16.00 <br /> 4/19/2000 2360 Underground Storage Tank EH Operating Permit Fee Tank#005 $170.00 <br /> 4/19/2000 2360 Underground Storage Tank EH Operating Permit Fee Tank#007 $170.00 <br /> 4/19/2000 2360 Underground Storage Tank EH Operating Permit Fee Tank#008 $170.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $636.00 <br /> Payment Due Date 5124/2000 <br /> TOTAL DUE this Billing Period 636. 0 <br /> Please make Checks PAYABLE to: PHS/EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> Penalties will beadded to all Permit Fees For all SERVICE FEES <br /> atthe Rate of 100%ofthe Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date and each 30 thereafter <br /> 4 <br /> MAY '1120 <br /> SANJnp,01104CWNIY <br /> PUFA-1e 4E/'•t?H SEWCES l`.. <br /> NVIRON;J.'cid-F1,.HrALTF:D:'+'•' <br /> 5256rpt <br />