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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTII..,T ./ <br /> 1868 E HAZELTON AVENUE <br /> STOCKGTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE Amount ID AR0038131 <br /> Facility ID FA0021146 <br /> LBNMNMNMNMMEMA <br /> Date Printed 1/29/2015 <br /> LMONEWEEMEMMONOM <br /> KINGSDOWN INC RE : KINGSDOWN INC <br /> 1631 INDUSTRIAL DR 1631 INDUSTRIAL DR <br /> STOCKTON, CA 95206 STOCKTON, CA 95206 <br /> OWNER : KINGSDOWN INC <br /> Date Health <br /> Program Oes ription. Amount <br /> Invoice# IN0263264---Date of Invoice: 1/29/2015 <br /> IIIIIIII III VIII VIII VIIIA VIII VIVA VIII VIIIIIIIIII 111111111 111 <br /> 1/29/2015 1921 HMBP-Regular-Primary Location $ 255.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 290.00 <br /> Payment Due Date 2/28/2015 <br /> TOTAL DUE this Billing Period $ 290.00 <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 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 /> 254 rpt <br />