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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />VALLEY OPERATORS <br />OLWD WELL #4 <br />PO BOX 690339 <br />STOCKTON, CA 95269-0339 <br />Page 1 <br />Account ID <br />AR0040340 <br />Facility ID <br />FA0022120 <br />Date Printed <br />10/31/2018-1 <br />RE: OLWD WELL #4 <br />1656 BELLA LAGO WAY <br />MANTECA, CA 95337 <br />OWNER: OAKWOOD LAKE WATER DISTRICT <br />Date Health <br />Program Description Amount <br />Invoice # IN0314579 --- Date of Invoice : 9/26/2018 <br />9/26/2018 1921 HMBP-Regular-Primary Location <br />9/26/2018 1922 CERS Processing Fee <br />9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />8EC4�'+� ti0i10E <br />IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII <br />$ <br />IIIIII VIII IIII III <br />313.00 <br />$ <br />30.00 <br />$ <br />49.00 <br />Total for this Invoice $ <br />392.00 <br />Payment Due Date <br />10/27/2018 <br />392.00 <br />TOTAL DUE this Billing Period <br />$ <br />Please make Checks PAYABLE to: 'EHD' – Return a Copy of This STATEMENT with Your PAYMENT <br />3enalties 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 />525-4.rpt <br />