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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 COPY <br /> INVOIC Amount 10 AR0030284 <br /> Facility ID FA0017402 <br /> Date Printed 1/30/2014 <br /> CHARLES S COX FARMS RE : CHARLES S COX FARMS <br /> PO BOX 1381 0 HWY 33 AT HWY 132 <br /> PATTERSON,CA 95363 VERNALIS, CA 95385 <br /> OWNER : CHARLES S COX FARMS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0249723—Date of Invoice: 1/3012014 111111'1II'l1 <br /> 1/3012014 1958 HM-Farm Operations $ 18.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 53.00 <br /> Payment Due Date 3/1/2014 <br /> TOTAL DUE this Billing Period $ 53.00 <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 />