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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 />TRILORE TECHNOLOGIES INC <br />3000 F DANVILLE BLVD #525 <br />ALAMO, CA 94507 <br />' Page 1 <br />Account ID <br />AR0016311 <br />Facility ID <br />FA0009311 <br />Date Printed <br />2/2/2016 <br />RE: TRILORE TECHNOLOGIES INC <br />4101 ARCH RD <br />STOCKTON, CA 95215 <br />OWNER: TRILORE TECHNOLOGIES INC <br />Date Health <br />Prrriram Description Amount <br />Invoice # IN0274593 --- Date of Invoice : 2/2/2016 <br />2/2/2016 1921 HMBP-Regular-Primary Location <br />2/2/2016 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />V <br />l� <br />O <br />V <br />IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII <br />VIII IIII <br />$ <br />IIIIII VIII IIII IIII <br />285.00 <br />$ <br />35.00 <br />Total for this Invoice <br />$ <br />320.00 <br />Payment Due Date <br />3/3/2016 <br />$ <br />320.00 <br />TOTAL DUE this Billing Period <br />PAYMENT <br />RECEIVED <br />FB 17 2015 <br />8AN JOAQUIN COUNT <br />ENVIRONMENTAL <br />HEALTH DEPARTMP-- <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />3enalties 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 />