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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1865 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0024537 <br /> INVOICE LMMMMMMMod <br /> Facility ID F FA0014457 <br /> LIMMEMMMMMOMM <br /> Date Printed 11/30/2017 <br /> Immmmmommmonamwo <br /> CRISTOPHER SANCHEZ RE : CRISTOPHERS AUTO REPAIR <br /> 731 E MINER AVE 731 E MINER AVE <br /> STOCKTON, CA 95205 STOCKTON, CA 95202 <br /> OWNER : CRISTOPHER SANCHEZ <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0298866---Date of Invoice: 912612017 1111111111111111111111111111111111 VIII IIII IIII <br /> 9/26/2017 1920 HMBP-Common Materials $ 98.00 <br /> 9/26/2017 1922 CERS Processing Fee $ 25.00 <br /> 9/26/2017 2220 SM HW GEN<5 TONSNR $ 249.00 <br /> 9/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 421.00 <br /> Payment Due Date 1 012 9/2 01 7 <br /> DTOTAL DUE this Billing Period $ 421.00 <br /> b"v'E WOULD WHIM P.TE YOUR <br /> TODAY! <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 /> 5254.rpt <br />