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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART4k 110 <br /> Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID F AR0005 886 <br /> LEMEMMMEEMEM <br /> INVOICE <br /> Facility ID FA0001134 <br /> Date Printed 3/2/2015 <br /> Immommommmmommo <br /> TURKMANY, GEORGE RE : TWO RIVERS RV PARK <br /> TWO RIVERS RV PARK 31021 S TWO RIVERS RD <br /> PO BOX 1424 MANTECA, CA 95337-9468 <br /> MANTECA, CA 95336 <br /> OWNER : TURKMANY, GEORGE <br /> Health <br /> Date Program Description Amount <br /> Invoice# IN0257385---Date of Invoice: 1111912014 IIIIIIIIIIII VIII VIII VIIVIII VIIIV IIIIIIIIIIIIIIIIIII VI IIII IIII <br /> Hrs Employee <br /> 10/10/2014 1921 306-FOLLOW UP FOR NON-COMPLIANCE 0.50 PARISSI $ 65.00 <br /> 2/15/2015 9988 SERVICE CHARGE PENALTY $ 6.50 <br /> Total for this Invoice $ 71.50 <br /> PAST DUE <br /> Invoice# IN0260491 ---Date ofInvoice: 1/2912015 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII(IIII(IIII(IIII(IIIIIIIIIIIIIIIIIIIIIIIIIIII IIII <br /> 1/29/2015 1921 HMBP-Regular-Primary Location $ 315.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00. <br /> Total for this Invoice $ 350.00 <br /> Payment Due Date 2/28120115 <br /> TOTAL DUE this Billing Period $ 421.50 <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 />