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SAN JOA'QUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTV%.wf \� <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOIC COPY Account ID AR0041404 <br /> LMMMEEMMEMMMM <br /> Faality ID FA0022623 <br /> Date Printed 2/4/2015 <br /> DELGADO,ANDRES RE : DELGADO AUTO REPAIR <br /> DELGADO AUTO REPAIR 101 W DR MARTIN LUTHER KING JR BLVD <br /> <br /> <br /> OWNER : DELGADO, ANDRES <br /> DateHealth <br /> i -Program Description Amount <br /> Invoice# IN0263448--Date of Invoice: 1/29/2015 11111111111111111111111pIN111111p1111p111p <br /> 1/29/2015 1920 HMBP-Common Materials $ 100.00 <br /> 1/29/2015 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00. <br /> Total for this Invoice $ 348.00 <br /> Payment Due Date 2/28/2015 <br /> TOTAL DUE this Billing Periodi $ 348.00 <br /> i <br /> ° S39s3 <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 />