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,AN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM� <br /> • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR00 77400 <br /> LMOMMEMMMMOWMEI <br /> Facility lD F FA00 00400 <br /> LMMMMONOMMOMEMI <br /> Date Printed 2/5/2004 <br /> KRAGEN AUTO PARTS#1137 RE : KRAGEN AUTO PARTS#1137 <br /> 1905 ASTON AVE 430 S CHEROKEE LN <br /> CARLSBAD, CA 92008 LODI, CA 95240 <br /> OWNER : CKS AUTO INC <br /> Date Health <br /> Proyram Description _ Amount <br /> Invoice# IN0116007—Date of Invoice: 2/4/2004 <br /> 2/4/2004 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 330.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice I $ 404.00 <br /> Payment Due Date 3/6/2004 <br /> ?AYMENT <br /> TOTAL DUE this Billing Period $ ` 404.00 <br /> --- -___ <br /> : FECEIVED <br /> MAR 12004 <br /> 3AN JOAOUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <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 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 101,1. 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 /> 5255.rpt <br />