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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 /> Account ID AR0024338 i <br /> INVOICE <br /> Facility ID FA0014323 <br /> Date Printed 9/27/2018 <br /> NU SHAKE ROOFING =NUSHAKE ROOFING <br /> 319 S PARALLEL AVE TRIAL PARK DR STE C,D,E <br /> RIPON, CA 95366-2910 CA 95336 <br /> OWNER : HEATH, DOUGLAS/HADL, ELIZABETH <br /> Date Health <br /> Prot'^ram. Description Amount <br /> Invoice# IN0312737---Date of Invoice: 9/26/2018 I IIIIIII IIIIII III VIII VIII ILII VIII VIII VIII VIII VIII VIII IIII IIIIII 11111 <br /> IIII IIII <br /> 9/26/2018 1921 HMBP-Regular-Primary Locatio $ 313.00 <br /> 9/26/2018 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2018 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC S ATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 641.00 <br /> Payment Due Date 10/27/2018 <br /> TOTAL DUE this Billing Period $ 641.00 <br /> C�ncS (S Npv,�-� d� <br /> �-c i i Gt22 c ss 1 <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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 52�4.rpt <br />