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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPART& <br />1868 E Hp+ RLtON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br /> <br /> <br />DEANA D ,1 <br />DDAY R ARE.COM <br />GRAIS V LEY, CA 95949 <br />Page 1 <br />Account ID I AR0041827 <br />Facility ID F FA0022803 <br />Date Printed 3/13/2015 mj <br />RE: VERUSCARE, INC <br />1110 S WILSON WAY STE 3 <br />STOCKTON, CA 95205 <br />OWNER: KEITH VIDETTO <br />Date Health <br />Program Description Amount <br />Invoice # IN0264678 --- Date of Invoice : 3/13/2015 <br />3/13/2015 1921 HMBP-Regular-Primary Location <br />3/13/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br />$ 255.00 <br />$ 35.00 <br />Total for this Invoice $ 290.00 <br />Payment Due Date 4/12/2015 <br />TOTAL DUE this Billing Period $ 290.00 <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />Denalties 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 />