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JAN JUAUUIN GUUN I Y <br /> ENVIRONMENTAL HEALTH DEPARTMF'- T Page 1 <br /> 304E WEAR AVE -3RD FLOOR <br /> STOCKTON, CA 95202 COPY <br /> Phone: (209)468-3420 <br /> INVOICE Account ID AR0016060 <br /> Facility ID FA0009060 <br /> Date Printed 1/30/2006 <br /> GLEN CAMPER RE : EARTH SHELTER <br /> EARTH SHELTER 412 S SACRAMENTO ST <br /> <br /> <br /> OWNER : CAMPER, GLEN <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0142547---Date of Invoice : 1/27/2006 1MIT 111111 111 11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 11111 IN IN <br /> 1/27/2006 2221 USED OIL ONLY-<5 TONS/YR $ 50.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 74.00 <br /> Payment Due Date 3/1/2006 <br /> TOTAL DUE this Billing Period $ 74.00 <br /> p CSI e T <br /> �D <br /> Sq,,,FE�o/i 1 � ='006 <br /> H ENVIq pN <br /> //v <br /> N7Y <br /> ��T H D�PAR AL T <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 Basa 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 />