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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMEO <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0035795 <br /> INVOICE <br /> Facility ID FA0020071 <br /> Date Printed 3/6!2015 <br /> COBB, RYAN P RE : CLUTCHES N MORE <br /> CLUTCHES N MORE 4629 N WEST LN 5 <br /> 1057 SPRINGOAK WAY STOCKTON, CA 95210 <br /> STOCKTON, CA 95209 <br /> OWNER : COBB, RYAN P <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0263126---Date of invoice: 112912015 1111 IN <br /> 1/29/2015 1920 HMBP-Common Materials ` $ 85.00 <br /> 1/29/2015 2220 SM HW GEN<5 TONSNR .00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br /> Total for this Invoice $�3 ABS <br /> Payment Due Date 2/28/2015 <br /> TOTAL DUE this Billing Period <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br /> For all SERVICE FEES <br /> Penalties will be added to all Permit Fees For HMBP Fees penalties will be added at the Rate of 10 <br /> at the Rate of 100%of the Base Fee 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 />