Laserfiche WebLink
SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMV Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccounuD F AR0017488 <br /> Facility ID F FA 00 0-4 88 <br /> Loommmommommi <br /> Date Printed 1/26/2007 <br /> LEEMENEENEEMMES <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# IN0156896---Date of Invoice: 1/25/2007 11111111111111111111 IN IIIIII 111111111 IN <br /> 1/25/2007 2220 SM HW GEN<5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZMAT FEE $ 130.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total forthis Invoicel $ 360.00 <br /> Payment Due Date 2/25/208 <br /> TOTAL DUE this Billing Period $ 360.0 <br /> PAYMENT <br /> RECEIVED <br /> FEB 1 4 2007 <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/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 /> 5254 rpt <br />