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_ <br />ti- __ <br />___---..... <br />__----�-----__ <br />T <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />COOPER OUT WEST <br />18636 E MILTON RD <br />LINDEN, CA 95236 <br />Page 1 <br />Account ID AR0030191 <br />Facility ID FA0017309 <br />Date Printed 1/30/2014 <br />RE: COOPER OUT WEST <br />19180 HARROLD <br />ESCALON, CA 95320 <br />OWNER: COOPER OUT WEST <br />Date Heaith <br />Proqram Description Amount <br />Invoice # IN0249654 --- Date of Invoice : 1/30/2014 <br />1/30/2014 1958 HM -Farm Operations <br />1/30/2014 2220 SM HW GEN <5 TONS/YR <br />1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII IIID VIII IIII <br />$ <br />IIIIII VIII Iill IIII <br />18.00 <br />$ <br />213.00 <br />$ <br />35.00 <br />Total for this Invoice $ <br />266.00 <br />Payment Due Date <br />3/1/2014 <br />$ <br />266.00 <br />TOTAL DUE this Billing Period <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />'enalties 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 />