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04-02-' 13 14:28 FROM- NorCal Foods DelTaco 209-521-8561 • T-092 P0002/0003 F-137 <br /> SAN JOAQUIN COUNTY • Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKPhone: ON,209 46 95205 COPY <br /> Phone: (209)468-3420 <br /> AccountlD AR0014800 <br /> �NVOIC <br /> Facility ID FA0007973 <br /> Date Panted 3/2812013 <br /> DEL TACO RE: DELTACO <br /> 678 N WILSON WAY <br /> 3421 TULLY RD STE G-1 STOCKTON,CA 95205 <br /> MODESTO,CA 95350 <br /> OWNER: NOR-CAL FOODS,INC <br /> Health Amount <br /> Date Program Description {{ II''II pp kk <br /> Invoice# IN0235743---Data of Invoice: 211/2013 I`fll�llll�l�lll�'III�IIIII�III�IIIII�IIIII�I�1ull llll'�'lll��l'IIIII�IIIIII��II <br /> $ 255.00 <br /> 21112013 1921 HMBP-RegulahPdmary Location $ 35.00 <br /> 21112013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br /> Total forthls Invoice $ 290.00 <br /> Payment Due Date 31312013 <br /> C> /1.' (��1"mIom i 290.00 <br /> 1 !S _ 6,?/ �t I. rr �-�a 1� TOTAL DUE this Billing Period $ <br /> �.: <br /> WE WOULD APPRECIATE YOUI3 <br /> PAYMENT 1T)CIM! <br /> Please make Checks PAYABLE to: 'EHlY Return a Copy of This STATEMENT with Your PAYMENT <br /> For HMBP Fees For all SERVICE FEES <br /> Penalties will be added to all Permit Fees Penalties will be <br /> added at the Rate of 10% <br /> at Yfia Rate of 100%of the Base Fee <br /> Penalties will be added at the Rate of 10% 60 Das after the Invoice Date and each 30 Days thereafter <br /> 30 Days after the Due Date 45 Days after the in <br /> Date Y <br /> 5254.rpt <br />