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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 /> INVOICE Account to <br /> Facility 10 FA0017214 <br /> Date Printed F 1/30/2014 <br /> LIEMMEEEEENNWM� <br /> COOPER OUT WEST RE : COOPER OUT WEST <br /> 18636 E MILTON RD 976 DUNCAN RD <br /> LINDEN, CA 95236 LINDEN, CA 95236 <br /> OWNER : COOPER OUT WEST <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0249579—Date of Invoice: 113012014 1111111 111111 III IIII III VIII I11I IIII ILII 111111 VIII 1111 IN <br /> 1/30/2014 1958 HM-Farm Operations $ 18.00 <br /> 1/3012014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Involee $ 53.00 <br /> Payment Due Date 31112014 <br /> TOTAL DUE this Billing Period $ 53.00 <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 HM13P 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 />