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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 186p �ELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0030290 <br /> Facility ID FA0017408 <br /> Date Printed 3/4/2015 <br /> MANUEL SILVA RE : MANUEL SILVA <br /> 2091 E GRANT LINE RD 24080 S BIRD RD <br /> TRACY, CA 95304 TRACY, CA 95304 <br /> OWNER : MANUEL SILVA <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0262663--Date of Invoice: 1/29/2015 IIIIIIIIIIIIIIIIIIIIIVIIIIIIIIIIIIIIIIIIIIIII VIIIIIIIIIIVIIIIIIIII <br /> 1/29/2015 1958 HM-Farm Operations $ 1800 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 53.00 <br /> Payment Due Date 2/28/2015 <br /> TOTAL DUE this Billing Period $ 53.00 <br /> i, <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />