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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM& . Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE AccountlD AR0003144 <br /> Facility ID FA0003565 <br /> LMIMMMMMMMOMMMA <br /> Date Printed F 5/12/2003 <br /> INEWOMMENNEMMOM <br /> UNIVERSAL SWEEPING SERVICES RE : UNIVERSAL SWEEPINGS SERVICES <br /> <br /> STOCKTON, CA 95215 <br /> OWNER : UNIVERSAL SWEEPINGS SERVICES <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0103507---Date of Invoice: 2127/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 330.00 <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 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2360 ADDITIONAL UST $ 125.00 <br /> 2/27/2003 2362 UST FACILITY& 1 TANK $ 500.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> 4/15/2003 9997 CORRECTION TO A CHARGE ($ 10.00) <br /> 4/15/2003 9997 CORRECTION TO A CHARGE ($ 500.00) <br /> 4/15/2003 9997 CORRECTION TO A CHARGE ($ 10.00) <br /> 4/15/2003 9997 CORRECTION TO A CHARGE ($ 125.00) <br /> 4/15/2003 9997 CORRECTION TO A CHARGE IS 10.00) <br /> 4/15/2003 9997 CORRECTION TO A CHARGE ($ 125.00) <br /> 4/16/2003 9999 PAYMENT ($ 530.00) <br /> Total for this Invoice $ 17.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 17.50 <br /> PAYMENT <br /> RECEIVED <br /> MAY 12 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <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 /> 5255.ipt <br />