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BILLING PRE 2019
Environmental Health - Public
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2200 - Hazardous Waste Program
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PR0514068
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BILLING PRE 2019
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Last modified
8/6/2019 2:56:05 PM
Creation date
8/6/2019 11:27:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0514068
PE
2227
FACILITY_ID
FA0009865
FACILITY_NAME
KIA COUNTRY
STREET_NUMBER
1515
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21619005
CURRENT_STATUS
01
SITE_LOCATION
1515 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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':-hN JOAQUI it COUNTY PURL LC IIL AL III 9LRVICL!; <br />ENVIRONMENTAI. HEALTH OIVI' N <br />304 E WEBER AVENUE — 3RD P�JOR <br />STOCKTON, CA 95202 <br />Accounting Office: 209.468-3420 <br />TO: C/O CAROL BREWER <br /> <br /> <br />ATTN: COUNTRY NISSAN <br />RE: COUNTRY NISSAN <br />151.5 N MAIN ST <br />I'd ANT ECA <br />Report 45255 <br />Sta lent Printed: 05/20/99 <br />�►aT ,U hs Te 1 �� <br />Account It 0016865 <br />Facility ID 009865 <br />PLEASE RETURN a COPY of THIS STATEMENT with YOUR PAYMENT <br />vac(, Activity <br />Date Oe cri ptton li EniployEe ArnoIu t. <br />Invoice # 057018 -- Date of Invoice: 05/18/99 <br />05 /18 /99 ?399 EINI FIED PROGRAM FAC STATE .SERVICE FEE $1P.50 <br />Total for this invoice: $18.50 <br />Payment DUE DATE /20/99 <br />if this INVOICE has been Paid, Please Oisregard this Notice <br />I. nice If 059204 -- Date of Invoice: <br />05/1"/99 ?220 SM HW GEN (!i TONS/YR <br />05/18/99 2399 UNIFIED PROGRAM FAC STATE <br />If this INVOICE has been Paid, Please Oisregard this Notice <br />Facility Name: <br />Facility Street Address: <br />City: <br />Contact Person: <br />05/18/99 <br />T.100.00 <br />SFRVICE FEE 110.00 <br />Total for this invoice: $110.00 <br />Payment DUE DATE 06/20/9 <br />Phone: 00 ouq -0003 <br />I certify that the only hazardous waste generated by the above referenced Facility is USED <br />OIL and that the total amoun{keneratefl pgr.yejir is less than 5 tons. <br />Signed: <br />A Division of San Joaquin County Health C Services <br />
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