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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0035640 <br /> INVOICE <br /> Facility ID FA0020015 <br /> Date Printed 2/2/2016 <br /> WINCHELL, JASON RE : J AND H SMOG AND REPAIR <br /> J AND H SMOG AND REPAIR 13336 E HWY 88 <br /> PO BOX 929 LOCKEFORD, CA 95237 <br /> LOCKEFORD, CA 95237 <br /> OWNER : WILLIAM LUTHER/WINCHELL, JASON <br /> Date Health <br /> t oro3r,m Description Amount <br /> Invoice# IN0276779---Date of Invoice: 2/2/2016 IIIIII II III VIIII IIIIIVIIIVI VIIIV IVI VIII IIIIII IIIIIIIIIIIII <br /> 2/2/2016 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 2/2/2016 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total forth is Invoice $ 248.00 <br /> Payment Due Date 3/3/2016 <br /> TOTAL DUE this Billing Period $ 248.00 <br /> NMENTAL HEALTH DEPARTMENT sl et <br /> SAN JOAQUIN COUNTY <br /> 1868 East Hazelton Avenue <br /> Stockton,Califomia 95205-6232 RECEIVED <br /> Return Service Requested t2%I06 " UL <br /> FEB 17 2016 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERVICES <br /> J <br /> �y N2XIE 957 DE 1.036 0002/13 /if, { <br /> � dl! <br /> RETURN TO SENDER <br /> VACANT <br /> UNABLE TO FORWARD <br /> 8C: 95205623268 I '' 2641- 00439-1.3 -05 <br /> Wit:=41:9:5''3'..81 t��6;2�-�':�': ILiIII�luHilllrlHll�ltnif�llilrll'r6H��l'�r�itrl)urllllllll <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 />