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SAN JOAQUIN COUNTY _ v <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE ° <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 MAY <br /> 0 6 2013 <br /> INVOICE ENITM Account ID AR0030034 <br /> ERMIT/SERVICE$ <br /> Facility ID FA00171 2— <br /> Date Printed 4/29/2013 <br /> lummemommonemoms <br /> J PIAZZA FARMS INC RE : J PIAZZA FARMS INC <br /> 711 CROSS ST 341 E ACAMPO RD <br /> LODI, CA 95242 LODI, CA 95240 <br /> OWNER : J PIAZZA FARMS INC <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0237447---Date ofinvoice: 2/1/2013 111111111 IN <br /> 2/1/2013 1958 HM-Farm Operations $ 18.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 53.00 <br /> Payment Due Date 3/3/2013 <br /> q D®® TOTAL DUE this Billing Period $ 53.00 <br /> � T DUE <br /> G <br /> Delinquent charges <br /> will be forwarded to <br /> COLLECTIONS <br /> in 30 days. <br /> n �1 <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 />