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SAN Ji AQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, 95205 <br /> Phone:e: (209(209)46 468-3420 p <br /> INVOICE FEB 1 9 2014 Account ID FARoOzsassli <br /> ENVIR(i;y ftgENT REAT� <br /> PERMIT/SERVICE$ Facility ID FA0016987 <br /> Date Printed 1/30/2014 <br /> J DELCARLO FARMS RE : J DELCARLO FARMS <br /> 835 W MARIPOSA AVE 11751 S WING LEVEE RD <br /> STOCKTON, CA 95204 STOCKTON, CA 95206 <br /> OWNER : J DELCARLO FARMS <br /> Date Heath <br /> Program Description Amount <br /> Invoice# IN0249406---Data of Invoice: 113 012 01 4 IIIIIIVIVIVII VIIVIVIIVIIVIIVIIIIIIIIII IIIIIIIII IIII <br /> 1/30/2014 1958 HM-Farm Operations $ 18.00 <br /> 1/30/2014 2220 SM HW GEN <5 TONS/YR 5 213.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 266.00 <br /> Payment Due Date 31112014 <br /> TOTAL DUE this Billing Period $ 266.00 <br /> 5 AU ZO 13 lit/ e n/U ,car Lo.✓�e v- <br /> Ar Wk +f-\'I S PfopP� Ayt�F <br /> FI T <br /> H <br /> 411 <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 /> -";,Pt <br />