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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEP RTM T Page 1 <br /> 3041, E WEBER AVE - 3RD FLOOR <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0016148 <br /> Facility ID FA0009148 <br /> Date Printed 3/4/2003 <br /> GURTEJ SINGH BRAR RE : PARK AVE CLEANERS <br /> PARK AVE CLEANERS 1296 W 11TH ST <br /> 2529 TRACY BLV6 TRACY, CA 95376 <br /> TRACY, CA 95376 <br /> OWNER : BRAR, GURTEJ SINGH <br /> Date Health <br /> Program Descriptio Amount <br /> Invoice# IN0103339---Date of Invoice: F/27/2003 <br /> 2/27/2003 2220 SM HW GEN<5 TONS/YR $ 200.00 <br /> 2/27/2003 2399 UNIFIED PROGRAM FAC STATE SERVICE FEE $ 17.50 <br /> Total for this Invoice $ 217.50 <br /> Payment Due Date 3/29/2003 <br /> TOTAL DUE this Billing Period $ 217.5 <br /> PAYMENT <br /> RECEIVED <br /> MAR 1 1 2003 <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH'Pl,,! 10N <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 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 />