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GAN 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 AR0041490 <br /> INVOICE <br /> Facility ID FA0022664 <br /> Date Printed 1/29/2019 <br /> PRIMO'S RE : PRIMO'S <br /> MAURO CERVANTES 2636 E FREMONT ST <br /> 2636 E FREMONT STOCKTON, CA 95205 <br /> STOCKTON, CA 95205 <br /> OWNER : MAURO CERVANTES <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0314634—Date of Invoice: 9/26/2018 11111 11111 1111 111111 11111 IN IN <br /> 9/26/2018 1921 HMBP-Regular-Primary Location $ 330.00 <br /> 9/26/2018 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2018 2220 SM HW GEN<5 TONSNR $ 249.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> 12/15/2018 9987 Haz Mat Program Penalty Fee $ 33.00 <br /> 12/15/2018 9994 PERMIT FEE PENALTY $ 249.00 <br /> Total for this Invoice $ 940.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 940.00 <br /> e,ir ,ent charges <br /> v�flk be -�crwarded t® <br /> jr,l 30 days. <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 />