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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> 155 <br /> INVOICE <br /> Facility ID FA0025493 <br /> Date Printed 9/27/2019 <br /> <br /> 14900 W SCHULTE RD <br /> 14900 W SCHULTE RD TRACY, CA 95377 <br /> TRACY, CA 95377 <br /> OWNER : LBA REALTY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0330166---Date of Invoice: 9/26/2019 I(IIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII 111111111 IIII <br /> 9/26/2019 1920 HMBP-Common Materials $ 98.00 <br /> 9/26/2019 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 177.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 177.00 <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 />