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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTP 'T Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account 10 —A R-0 117188 <br /> Facility ID FA0010188 <br /> Date Pnnted F 1/24/2005 <br /> <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : MARK ANTONINI, J ANTONINI <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128233—Date of Invoice: 1/24/2005 IIIIIIIIIIIVIIIIIVIIIVIIVIIIVIIVIIIVIIIVIIIIII IIIIIIIIIIIIIII IIII <br /> 1/24/2005 2220 SM HIN GEN<5 TONSNR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 375.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 599.00 <br /> Payment Due Date 2/2312005 <br /> TOTAL DUE this Billing Period $ 599.00 <br /> PAYMeN f <br /> RECEIVED <br /> FES 12005 TY <br /> BAN <br /> pJOIRONI <br /> jVMENTAL <br /> }IFJU-TH DEPkRTME"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 DES/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 /> _7 i i rpt <br />