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SA 'JOAQUIN COUNTY • • <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 COPY <br /> INVOICE Account ID AR 00 000 00 <br /> Facility ID FA0017128 <br /> Date Printed 1/30/2014 <br /> BATESFARMS RE: BATESFARMS <br /> PO BOX 1227 21200 N DAVIS RD <br /> WOODBRIDGE, CA 95258 LODI, CA 95240 <br /> OWNER: BATES FARMS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0249505---Date of invoice: 1130/2014 11111111P111III 1111111p1111111111111111111111111111111111[1111111111111111111 <br /> 1/30/2014 1958 HM-Farm Operations $ 18.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total fort his Invoice $ 53.00 <br /> Payment Due Date 3/1/2014 <br /> TOTAL DUE this Billing Period $ 53.00 <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 />