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SAN ,iOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPART' 4T <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0008233 <br /> Facility ID FA0003769 <br /> Date Printed 1/24/2005 <br /> TERESI TRUCKING INC RE : TERESI TRUCKING INC <br /> <br /> LODI, CA 95240 <br /> OWNER : TERESI TRUCKING INC <br /> Health <br /> Date orog'arn Description _ Amount <br /> Invoice# IN0128942—Date of Invoice: 1/24/2006 I IIIIIII III III 11111 11111 VIII IIIII IIIII VIII VIII IIIII lull IIII IIII Illi IIII IIII <br /> 1/24/2005 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 390.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoice $ 614.00 <br /> Payment Due Date 2/23/ 5 <br /> TOTAL DUE this Billing Period $ 614.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 5 2005 <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 OES/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 /> 52i5 rpt <br />