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SAN JOAQUIN COUNTY <br /> ENVIROi.MENTAL HEALTH DEPAIRTM' Page 1 <br /> 304 E WEBER AVE -3RD FLOOR <br /> STOCKTON, CA 95202 <br /> <br /> nt ID I. AR0017975 <br /> Facility ID FA0010975 <br /> Date Printed 1/30/2006 <br /> KRAGEN AUTO PARTS #1482 RE : KRAGEN AUTO PARTS#1482 <br /> 1905 ASTON AVEI 309 W CHARTER WAY <br /> CARLSBAD, CA 92008 STOCKTON, CA 95206 <br /> OWNER : CSK AUTO INC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0143136---Date of Invoice: 1/27/2006 11111 1111 111111 11111 1111 IN <br /> 1/27/2006 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 1/27/2006 2244 2006 HAZNI AT FEE $ 270.00 <br /> 1/27/2006 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 24.00 <br /> Total for this Invoice $ 494.00 <br /> Payment Due Date 3/1 <br /> TOTAL DUE this Billing Period $ 494.00 <br /> P CIVT <br /> REcSjVEp <br /> FEB 2 4 Zoos <br /> S EN OAQUm/oODN <br /> HEALTH D pAR-W <br /> Please make Checks PA ABLE 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 /> 52>4.rpt <br />