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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 />—Health -- - _ - - - - <br />Date Program Description <br />Invoice # IN0236900 -- Date of Invoice: 2/1/2013 <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 />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 />Amount <br />I (IIIIII 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 3/3/2013 <br />TOTAL DUE this Billing Periodl $ 563.00 <br />4 <br />I Q ++I i gPRo D <br />Hez-vz C10.5t? Cj iJi.�:5 �rsS ike to �tle- 1Jrt�t r+5�1���:�� FIVUj'(9 '2013 <br />L.")e— 4C "A k4l'k/le <br />P P�RM�rMF"rti <br />CLL tet, C F j_ <br />11 cjc�3- i ct3i 1441 Icy <br />oma-aus <br />i n-ss 6C4�h��-o�l�. <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 />5254.rpt <br />