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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA <br /> <br /> <br /> <br /> <br /> <br /> <br /> Y FARMS #13566 3200 S NAGLEE RD <br /> 2510 HAVEN AVE TRACY, CA 95376 <br /> JOLIET, IL 60433 <br /> OWNER : HICKORY FARMS LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0323184---Date of Invoice: 6/13/2019 11111 1111 111111 11111 1111 IN <br /> 6/13/2019 1699 TEMPORARY INCIDENTAL FOOD $ 55.00 <br /> Total for this Invoice $ 55.00 <br /> Payment Due Date 7/13/2019 <br /> TOTAL DUE this Billing Period $ 55.00 <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 /> 5254.rpt <br />