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SAN JOAQUIN COUNTY * Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> COPY Account ID AR0003137 <br /> INVOICE <br /> Facility ID FA0003559 <br /> Date Printed 9/27/2018 <br /> LKQ ACME TRUCK PARTS RE : LKQ ACME TRUCK PARTS <br /> 1016 S WILSON WAY 2546 TURNPIKE RD <br /> STOCKTON, CA 95205 STOCKTON, CA 95206 <br /> OWNER : LKQ AUTO PARTS OF CENTRAL CA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0311944---Date of Invoice: 9/26/2018 11111111 E111 E 11111 11111 11111 1111 11111 1111 1111 11111 11111 1111 111111 11111 1111 IN <br /> 9/26/2018 1921 HMBP-Regular-Primary Location $ 313.00 <br /> 9/26/2018 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 392.00 <br /> Payment Due Date 10/27/2018 <br /> TOTAL DUE this Billing Period $ 392.00 <br /> Ivi a ,� <br /> �44 OCT © 1 <br /> cNTAL HF,OL.d <br /> An0 ' a <br /> o <br /> ( m <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 />