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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> INVOICE Account ID AR0017341 <br /> Facility ID F FA0010341 <br /> LMOOMMMMMMMA <br /> Date Printed 2/1/2013 <br /> O'REILLY AUTO PARTS#2769 RE : O'REILLY AUTO PARTS#2769 <br /> <br /> STOCKTON, CA 95207 1 <br /> OWNER : C—Kt-AVTOIMC0\I,P I y <br /> C-511 oto ioc UJ'( <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0236300---Date of Invoice: 2/112013 111 lllllllllllullullulululllullulllll 111111111111111 111 <br /> 2/1/2013 1921 HMBP-Regular-Primary Location $ 315.00 <br /> 2/1/2013 2220 SM HVJ GEN<5 TONS/YR $ 213.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 563.00 <br /> Payment Due Date -3/3M013� <br /> TOTAL DUE this Billing Period $ 563.00 'I <br /> J <br /> PAYMENT <br /> RECEIVED <br /> FEB 2 8 1013 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEA1-Th'DEPAFiTV,ENT <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 DES I HMMP 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 />