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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 COPY Account ID AR0006271 <br /> INVOICE Facility ID FA0005635 <br /> Date Printed 2/28/2017 <br /> JEFF FRENCH RE : SJ LUMBER COMPANY <br /> SAN JOAQUIN LUMBER COMPANY 235 W SCOTTS AVE <br /> PO BOX 1900 STOCKTON, CA 95203 <br /> STOCKTON, CA 95201 <br /> OWNER : SAN JOAQUIN LUMBER COMPANY <br /> Date Health Amount <br /> Program Description <br /> Invoice# IN0287192---Date of Invoice: 1/2612017 11111HE111111111111111TIIII E1111111111111111111111111111111111I IN <br /> $ 284.00 <br /> 1/26/2017 1921 HMBP-Regular-Primary Location $ 25.00 <br /> 1/26/2017 1922 CERS Processing Fee $ 35.00 <br /> 1/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 675.00 <br /> 1/26/2017 2832 AST FAC 10 K-</=100 K GAL CUMULATIVE $ 26.00 <br /> 1/26/2017 APSA APSA SURCHARGE <br /> Total for this Invoice j $ 1,045.00 <br /> Payment Due Date 2/25/2017 <br /> TOTAL DUE this Billing Period $ 1,045.00 <br /> 3 ,'51 -7 <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 />