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SAN JOAQUIN COUNTY <br /> EIVORONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0020339 <br /> INVOICE <br /> Facility ID FA0012477 <br /> Date Printed 12/6/2018 <br /> CALIFORNIA AUTO TECH RE : CALIFORNIA AUTO TECH <br /> 321 N STANISLAUS ST. 510 E MINER AVE <br /> STOCKTON, CA 95202 STOCKTON, CA 95202 <br /> OWNER : AHMADZAI, ZOHRAH <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0312480---Date of Invoice: 9/26/2018 11111 IIIIII III VIII VIII 1111$11111 <br /> IIIVIIIVIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 9/26/2018 1920 HMBP-Common Materials $ 1149.00 <br /> 9/26/2018 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2018 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE S 4900 <br /> Total for this Invoice $ 477.00 <br /> Payment Due Date 10/27/2018 <br /> TOTAL DUE this Billing Period $ 477.00 <br /> P - s <br /> p'� <br /> �.� <br /> O V � � l✓� <br /> l�. <br /> y <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 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 52>a.rpl <br />