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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTN 'T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0017623 <br /> Facility ID F FA0010623 <br /> Date Panted F 2/5/2004 <br /> SAM LUNG LAUNDRY INC RE : SAM LUNG LAUNDRY INC <br /> 742 E MAIN ST 742 E MAIN ST <br /> STOCKTON, CA 95202-3131 STOCKTON, CA 95202-3120 <br /> OWNER : SAM TOY <br /> Do,o Health <br /> Program Description. Amount <br /> Invoice# IN0116066—Date of Invoice: 2/4/2004 <br /> 2/4/2004 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/4/2004 2244 2004 HAZMAT FEE $ 255.00 <br /> 2/4/2004 2399 UNIFIED PROGRAM FAC STATE SERI.ICE FEE $ 24.00 <br /> Total for this lnvolce $ 479.00 <br /> Payment Due Date 3/6/2004 <br /> PAYMENT - <br /> RECEIVED TOTAL DUE this Billing Period $ 479.00 <br /> MAR 12004 <br /> SAN JOAQUIN 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 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 /> 5255.rpt <br />