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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTII F Page 1 <br /> 1868 E HAZELTON AVENUE .i <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID F AR0029928 <br /> Facility ID FA0017046 <br /> Date Printed 2/20/2013 <br /> -= m-o <br /> TEIXEIRA DAIRY RE : TEIXEIRA DAIRY <br /> 2455 NAGLEE RD 21150 MT HOUSE PKWY <br /> TRACY, CA 95304 TRACY, CA 95304 <br /> OWNER : TEIXEIRA DAIRY <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0237368---Date of Invoice : 2/1/2013 IIIIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 2/1/2013 1958 HM-Farm Operations $ 18.00 <br /> 2/1/2013 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE S 35.00 <br /> Total for this Invoice $ 266.00 <br /> Payment Due Date 3/3/2013 <br /> TOTAL DUE this Billing Period $ 266.00 <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 /> I <br />