Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTNW Page 1 <br /> 304 E WEBER AVE -3RD FLOOR • <br /> STOCKTON, CA 95202 <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0017488 <br /> LMMEMMMMMMMMOM <br /> Facility ID F FA00 00488 <br /> Date Printed 1/24/2005 <br /> LMNOMMENEEMOMMON <br /> RICKY CHAM RE : ULTRACARE OF STOCKTON <br /> ULTRACARE OF STOCKTON 4629 N WEST LN STE 10 <br /> <br /> <br /> OWNER : CHAM, RICKY K <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0128327---Date of Invoice: 1/24/2005 IIIIIIIIII III VIII VIII VIII VIII VIII VIVIII VIII VIII IIII IIIIII 111111111 111 <br /> 1/24/2005 2220 SM HW GEN <5 TONS/YR $ 200.00 <br /> 1/24/2005 2244 2005 HAZMAT FEE $ 130.00 <br /> 1/24/2005 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 24.00 <br /> Total for this Invoicel $ 354.00 <br /> Payment Due Date 212312005 <br /> TOTAL DUE this Billing Period $ 354.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 7 2005 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'El — 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.rpt <br />