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SAI)JOAQUIN COUNTY <br /> EWs/IRONMENTAL HEALTH DEPARTMI • Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0018053 <br /> Facility ID FA0011053 <br /> Date Printed 2/27/2003 <br /> CHAMPION RE : CHAMPION <br /> 1301 N EUCLID AVE 1220 VANDERBILT CIR <br /> PRINCETON, IL 61356 MANTECA, CA 95336 <br /> OWNER : GARDNER DENVER INC <br /> Date Health <br /> Pronram Description <br /> Amount <br /> Invoice# IN0103960---Date of Invoice: 2/27/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONSNR $ 200.00 <br /> 2/27/2003 2244 2003 HMMP Annual Fee $ 315.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 532.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Periodi $ 532.50 <br /> RECEIVE p <br /> MAR 10 2003 <br /> SA JOAOIJ <br /> ENVCOUN 1-y <br /> IRCNMEHEA <br /> AAL 1""SFR p ESN <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 />