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.OUNTY Page 1 <br /> 0 <br /> � aTAL HEALTH DEPARTMENT <br /> LELTON AVENUE <br /> i ON, CA 95205 <br /> Ie: (209) 468-3420 <br /> Account ID AR0005843 <br /> INVOICE Facility IDFA0005381 <br /> Date Printed 3/4/2015 <br /> J LOMBARDI FARMS RE : JLOMBARDIFARMS <br /> 16998 E GAWNE RD 29665 KASSON RD <br /> STOCKTON, CA 95215 TRACY, CA 95376 <br /> OWNER : J LOMBARDI FARMS <br /> Date Health Amount <br /> Program Description <br /> Invoice# IND260548---Date of Invoice: 1129/2015 111111111 Hill IIIII IIIIIIIIII1111111111111111111111111111111111111111111 IIII <br /> 1/29/2015 1958 HM-Farm Operations $ 18.00 <br /> 1/29/2015 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 1/29/2015 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Involve $ 266.00 <br /> MOM <br /> Payment Due Date 2126/2015 <br /> Invoice# IN0263714---Date of Invoice: 2/512015 MAR 16 ZW5 I1111111I I IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII(IIIII IIIII IIII IIII <br /> 2/5/2015 APSA APSA SURCHARGEEPlVIflOPIMENT HEPLTH $ 26.00 <br /> INITISFKVICES <br /> �LI� Total for this Invoice § 26.00 <br /> Payment Due Date 3/812015 <br /> f' TOTAL DUE this Billing Period $ 292.00 <br /> 6o, <br /> ' 44.4 <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 />