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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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2200 - Hazardous Waste Program
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PR0514378
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BILLING_PRE 2019
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Entry Properties
Last modified
5/22/2019 2:05:38 PM
Creation date
11/1/2018 10:57:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
BILLING_PRE 2019
FileName_PostFix
PRE 2019
RECORD_ID
PR0514378
PE
2220
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
01
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\K\KETTLEMAN\420\PR0514378\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
3/9/2018 10:48:23 PM
QuestysRecordID
3824864
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN JOAQUIN COUNTY <br /> ENVJRONMENTAL HEALTH DEPARTMO • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> �Lv <br /> INVOICE AccountlD AR0003356 <br /> Facility ID FA0003776 <br /> Date Pnnted 3/4/2003 <br /> TOKAY SHELL* VRE : TOKAY SHELL* <br /> <br /> LODI, CA 95240 <br /> OWNER : SHELL OIL PRODUCTS US <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0103863--Date of Invoice: 2/27/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 130.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.00 <br /> 2/27/2003 2301 UST STATE SURCHARGE $ 10.0 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2362 UST FACILITY&1 TANK $ 5 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 \ <br /> Total for this Invoice $ 1,397.50 <br /> Payment Due Date -x/29/2003 <br /> PAYMENT TOTAL DUE this Billing Period $ 1,397.50 <br /> RECEIVED <br /> MAR 10 2003 <br /> PUBLICO HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH OMS --N <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 all SERVICE FEES <br /> at the Rate of 100%of the 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 Days thereafter <br /> 5255.rpt <br />
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