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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMO Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0005769 <br /> Facility ID FA0005307 <br /> Date Printed 12/30/2002 <br /> TRC RE : HOLZ RUBBER CO <br /> HOLZ RUBBER CO 1129 S SACRAMENTO ST <br /> 5052 COMMERCIAL CIR LODI, CA 95240 <br /> CONCORD, CA 94520-1248 <br /> OWNER : DRYBURGH, JIM <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0101776---Date of Invoice: 12/16/2002 <br /> Hrs Employee <br /> 11/4/2002 2960 312-CONSULTATION 0.50 KNOLL $ 44.50 <br /> 11/6/2002 2960 310-FIELD CONSULT 2.00 KNOLL $ 178.00 <br /> 11/25/2002 2960 315-REPORT REVIEW 1.00 KNOLL $ 89.00 <br /> Total for this Invoice $ 311.50 <br /> Payment Due Date 1/18/2003 <br /> TOTAL DUE this Billing Period $ 311.50 <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 all SERVICE FEES <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 Days thereafter <br /> 5255.rpt <br />