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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 /> INVOICE Account to AR0040756 <br /> Facility ID FA0022324 <br /> LMOMMONOMMUMA <br /> Date Printed 6/26/2014 <br /> GARY CHASTAIN RE : CROWNE COLD STORAGE <br /> CROWNE COLD STORAGE 2323 PORT ROAD G STE B <br /> 18512 AVENUE 4 STOCKTON, CA 95203 <br /> DELANO, CA 93215 <br /> OWNER: DAVID AND KABLE MUNGER <br /> Date Hea;tn <br /> Program Description <br /> Amount <br /> Invoice# IN0253763---Date of Invoice: 6/12/2014 IIIIII1IIII111Iillll VIII VIIVIIIVIIIVIIIVIII IIIA IIII 11111111111 IIII IIII <br /> 6/12/2014 1921 HMBP-Regular-Primary Location $ 255.00 <br /> 6/12/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 290.00 <br /> Payment Due Date 7/12/2014 <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 /> 5254.rpt <br />