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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />LODI GRADING & PAVING INC <br /> <br /> <br />Page 1 <br />Account ID <br />AR0025636 <br />Facility ID <br />FA0015000 <br />Date Printed <br />3/28/2013 <br />RE: LODI GRADING & PAVING INC <br />9211 E HWY 12 <br />LODI, CA 95240 <br />OWNER: MICHAEL R JENNINGS <br />Date <br />—Health <br />Prooram Description <br />Amount <br />Invoice # IN0236900 -- Date of Invoice : 2/1/2013 <br />2/1/2013 1921 HMBP-Regular-Primary Location <br />2/1/2013 2220 SM HW GEN <5 TONSNR <br />2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />'��~i �y�\ � �^rte ��;••5fi� ';?r"�"��� <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br />$ 315.00 <br />$ 213.00 <br />$ 35.00 <br />Total for this Invoice $ 563.00 <br />Payment Due Date 313/2013 <br />TOTAL DUE this Billing Period $ 563.00 <br />4 <br />I II Q i F APR o� D <br />2013 <br />1 <br />We 4PERM/TMENrh <br />�� SF(��l FA�Ty <br />Q y l W <br />p awsIn,_,SS <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 thereafte <br />254.rpt <br />