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COUGKWFWJ (2)
Environmental Health - Public
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ARMSTRONG
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2500 – Emergency Response Program
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COUGKWFWJ (2)
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Last modified
3/23/2022 4:02:41 PM
Creation date
3/23/2022 3:53:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COUGKWFWJ
PE
2546
STREET_NUMBER
5839
Direction
E
STREET_NAME
ARMSTRONG
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06107025
ENTERED_DATE
7/6/2020 12:00:00 AM
SITE_LOCATION
5839 E ARMSTRONG RD
RECEIVED_DATE
7/6/2020 12:00:00 AM
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Page No <br />Due Date <br />44 k <br />REPUBLIC <br />SERVICES <br />Total Amount Due <br />Please pay total amount due <br />Billing Questions? Call (209) 466-4482 <br />INVOICE <br />Invoice Date 07/31/2020 <br />Invoice No 4204-000055663 <br />Customer No 4-4204-0009166 <br />Page 1 of 1 <br />UPON RECEIPT <br />Current Charges <br />IMSSF2214taill <br />FORWARD INC - 4204 <br />PO BOX 31001-2265 <br />PASADENA, CA 91110-2265 <br />(209) 466-4482 <br />P S C <br />ACCOUNTS PAYABLE <br />2050 WEST FREMONT STREET <br />STOCKTON, CA 95203 <br />7/23 VG SW-CONT SOIL Y8-1484276 32.25 3.58 TN $200.00 <br />7/23 VG Reference: 6000923/Do # 17820010002i0670 <br />7/23 VG Vehide: PSC 190830 <br />7/23 VG Contract: 4204Y911178 <br />7/23 VG Generator Name: PG&E <br />7/31 02 SJ Cnty I AB 939 Fee at $2.00/TN on 0.00 $7.16 <br />3.58 <br />7/31 03 SJ Cnty / Rd Mitigation Fee at $0.18/TN <br />on 3.58 <br />0.00 $0.64 <br />7/31 06 SJ Cnty / Env Health Fee at $0.09/TN <br />on 3.58 <br />0.00 $0.32 <br />Material / Fee Summary <br />02 S3 Cnty / AS 939 Fee at $2.00/TN 3.58 $7.16 <br />03 Cnty / Rd Mitigation Fee at $0.18/TN 3.58 $0.64 <br />06 53 Cnty / Env Health Fee at $0.09/TN 3.58 $0.32 <br />VG SW-CONT SOIL 3.58 TN $200.00 <br />P3f 2-009 <br />113. -b )3(e59 <br />c6- toDa_-- -satri <br />I6-otr71111 ifilrffo1b-111 itarraIDITialitolIrtkmount Due <br />$3,759.87 $1,514.54 $0.00 . $0.00 $5,274.41 <br />please return thilportion below with your_payirtent. Do not attach check stub. <br />Invoice Date 07/31/2020 <br />Invoice No 4204-000055663 <br />Customer No 4-4204-0009166 <br />FORWARD INC - 4204 <br />PO BOX 31001-2265 <br />PASADENA, CA 91110-2265 <br />REPUBLIC (209) 466-9482 <br />SERV7CES <br />Please write your account number on your check and make payable to: <br />Please FORWARD INC - 4204 <br />Return PO BOX 31001-2265 <br />Payment to: PASADENA, CA 91110-2265 <br />IMPORTANT! To avoid duplicate payments, Please pay the CURRENT CHARGES on each <br />Invoice. Also, please send the remittance with your payment. Thank you! <br />Current Charges <br />$208.12 <br />Total Amount Due $5,274.41 <br />Amount Paid: <br />P S C <br />ACCOUNTS PAYABLE <br />2050 WEST FREMONT STREET <br />STOCKTON, CA 95203
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