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SAN JOAQUIN COUNTY _ <br /> ENVIRONMENTAL HEALTH DEPARTk. ,,T �../ Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0039949 <br /> Facility ID FA0021922 <br /> Date Printed F 1/29/2015 <br /> TUFFSHED RE : TUFFSHED <br /> 2754 TEEPEE DR STE B 2754 TEEPEE DR STE B <br /> STOCKTON, CA 95205-2402 STOCKTON, CA 95205 <br /> OWNER : TOM SAUREY <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0263329---Date <br /> o�fflI dice: 1/29/2015 111111111 IN <br /> 1/29/20151 0 '"1 YH\MBP-Common Materials �j i $ 70.00 <br /> 1/29/2015 UNIFIED PROGRAM FAC STATE SURCHARGE FEE E �$ 35.00 <br /> otal for this Invoice $ 105.00 <br /> 117 Payment Due Date 2/28/2015 <br /> TOTAL DUE this Billing Period $ 1 0 <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 />