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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0039202 <br /> INVOICE <br /> Facility ID FA0001909 <br /> Date Printed 1/29/2019 <br /> STOP N SHOP RE : STOP N SHOP <br /> JAGRAJ SINGH RAR 1856 W COUNTRY CLUB BLVD <br /> <br /> <br /> OWNER : JAGRAJ SINGH BRAR <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0313712---Date of Invoice: 9/26/2018 111111 111 11111�IM 11111 11111 111 11111 11111 1111 11111 1111 1111 111M 1EI 1111111 <br /> 9/26/2018 1920 HMBP-Common Materials $ 98.00 <br /> 9/26/2018 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2018 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2018 2301 UST STATE SURCHARGE FEE $ 20.00 <br /> 9/26/2018 2301 UST STATE SURCHARGE FEE $ 20.00 <br /> 9/26/2018 2360 UST-PER TANK FEE $ 228.00 <br /> 9/26/2018 2360 UST-PER TANK FEE $ 228.00 <br /> 9/26/2018 2361 UST FACILITY $ 680.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> 12/15/2018 9987 Haz Mat Program Penalty Fee $ 9.80 <br /> 12/15/2018 9994 PERMIT FEE PENALTY $ 228.00 <br /> 12/15/2018 9994 PERMIT FEE PENALTY $ 228.00 <br /> 12/15/2018 9994 PERMIT FEE PENALTY $ 680.00 <br /> 12/15/2018 9994 PERMIT FEE PENALTY $ 249.00 <br /> Total for this Invoice $ 2,996.80 <br /> PAST DUE <br /> ATTENTION TOTAL DUE this Billing Period $ 2,996.80 <br /> YOUR HEALTH PERMIT FOR <br /> THE CURRENT YEAR <br /> WILL NOT BE ISSUED UNTIL <br /> PAST DUE AMOUNTS <br /> ARE PAID IN FULL <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 HMBP 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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 52S.1.rp( <br />