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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPART&* Page 1• <br /> 1868.E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> AMENDED <br /> Account ID I AR0030313 <br /> INVOICE <br /> Facility ID FA0017431 <br /> Date Printed 2/6/2015 _ <br /> LIEN'S POULTRY& EGG FARM RE : LIENS POULTRY& EGG FARM <br /> PO BOX 663 30636 E CARTER RD <br /> CERES, CA 95307 FARMINGTON, CA 95230 <br /> OWNER : LIEN'S POULTRY& EGG FARM <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0263995---Date of Invoice: 2/5/2015 11111111 IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII 1111111111 VIII I'll IIII <br /> 2/5/2015 APSA APSA SURCHARGE $ 26.00 <br /> Total for this Invoice $ 26.00 <br /> Payment Due Date 3/8/2015 <br /> TOTAL DUE this Billing Period $ 26.00 <br /> VW C,,,,eCIA� <br /> Vt <br /> s <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 />