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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM' Page 1 <br /> 304 E WEBER AVE -3RD FLOOR - <br /> STOCKTON, CA 9 <br /> <br /> NVOIC " AccountID AR0017975 <br /> ;c <br /> i, Facility ID FA0010975 <br /> ------ Date Printed 1/26/2007 <br /> KRAGEN AUTO PARTS #1482 RE : KRAGEN AUTO PARTS#1482 <br /> 1905 ASTON AVE 309 W CHARTER WAY <br /> CARLSBAD, CA 92008 STOCKTON, CA 95206 <br /> OWNER : CSK AUTO INC <br /> Date Health <br /> Program Descriptio Amount <br /> Invoice# IN0156978---Date of Invoice: 1/25/2007 1111 111111 11111 1111 IN <br /> 1/25/2007 2220 SM HW G N <5 TONS/YR $ 206.00 <br /> 1/25/2007 2244 2007 HAZ AT FEE $ 270.00 <br /> 1/25/2007 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 500.00 <br /> Payment Due Date 2/25/2007 <br /> TOTAL DUE this Billing Period $ 500.00 <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 0 Luo? <br /> SAN JOAQUIN COUNTY <br /> H�THDEPARTMENT <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 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 />