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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOIC COPY Amount ID AR0002858 <br /> Facility ID F FA0003284 <br /> Date Printed 10/24/2016 <br /> LAL, JOGINDER RE : FOOD MART GASOLINE* <br /> JOGINDER LAL 2185 E FREMONT ST <br /> 125 EAST WINNEMUCCA BLVD. STOCKTON, CA 95205 <br /> WINNEMUCCA, NV 89445 WNER : LAL, JOGINDER Q�Q <br /> �a M��. s � <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0282890---Date of Invoice: 9/21/2016 1111111 IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII <br /> Hrs Employee <br /> 8/8/2016 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.3 RIVERA $ 41.70 <br /> 8/23/2016 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0. 0 RIVERA $ 41.70 <br /> �Rosa"I � SS Totalforthislnvoice $ 83.40 <br /> Payment Due Date 10/22/2016 <br /> I^{O vN�a TOTAL DUE this Billing Period $ 83.40 <br /> Nabocagg <br /> SIC <br /> P <br /> I e C�AAP-� <br /> pYl a� Z <br /> � f CIX 9s� � <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 /> 5?Sd mt <br />