Laserfiche WebLink
SAN JOAQUIN COUNTY PUBLIC 1-ftI SERVICES Page 1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 E WEBER AVE-3RD FLOOR <br /> STOCKTON, CA 95202 <br /> 209-468-3420 <br /> INVOICE Account ID AR0017097� <br /> Facility ID FA0010097 <br /> Date Printed 4/25!00 <br /> DAVID W POTTS RE: STOCKTON AUTO DISMANTLERS IN <br /> STOCKTON AUTO DISMANTLERS INC 3239 S EL DORADO ST <br /> 3239 S EL DORADO ST STOCKTON CA 95206 <br /> STOCKTON CA 95206 OWNER: DAVID W POTTS <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0070635--Date of Invoice: 4/19/00 <br /> 4/19/2000 2220 SM HW GEN<5 TONS/YR $100.00 <br /> 4/19/2000 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $10.00 <br /> Total for this Invoice $110.00 <br /> Payment Due Date 5/ 0 <br /> TOTAL DUE this Billing Period $110.00. <br /> MMMMMA <br /> Please make Checks PAYABLE to: PIIS/EHD / Return a Copy of This STA'FENIENT with Your PAYMENT <br /> Penalties will tx:added to all Permit Fees For all SERVICE.FLFS <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 thereafter <br /> ----------------------------------------------------------------- ----------- -- <br /> t SE OIL 0NLY� r <br /> Facility Name: • ->✓� w t S ltiLL4 /"Zl /-) 1 G�L <br /> Facility Street Address: <br /> City: <br /> Contact Person: <<v <br /> "�� — Phone: <br /> G <br /> I certify that the only hazardous waste generated by the/al)ove referenced Facility is USED <br /> OIL and that the total amount ge Rated p year is less f. pn S tons. <br /> Signed• �•� <br /> A Division of San Joaquin County Health Care Services <br /> 5255.rpt <br />