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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> AR0017948 <br /> INVOICE <br /> Facility ID FA0010948 <br /> Date Printed 9/27/2019 <br /> FRONTIER PERFORMANCE LUBRICANTS INC RE : FRONTIER PERFORMANCE LUBRICANTS <br /> PO BOX 1777 INC <br /> LODI, CA 95241-1777 816 BLACK DIAMOND WAY A <br /> LODI, CA 95249-0720 <br /> OWNER : FRONTIER PERFORMANCE LUBRICANT <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0327722---Date of Invoice: 9/26/2019 111111111111 E 11111 11111 11111 INI 11111 11111 11111 1111�1111 111 111111 11�1111 IN <br /> 9/26/2019 1921 HMBP-Regular-Primary Location $ 653.00 <br /> 9/26/2019 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2019 2220 SM HW GEN<5 TONSNR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 981.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 981.00 <br /> PRODREGEV.'w:� <br /> Cell ,• , <br /> Office :,, 807-4496 <br /> Kari L. Markel Fax(209)334-6408 OCT 0 9 2019 <br /> SAN Jvf.QUIN COUNTY <br /> ENVIRONMENTAL <br /> ` �n� / <br /> HEALTH DEPARTMENT <br /> � <br /> (19 <br /> We <br /> add-lYSs IS <br /> 6m zwawe zl <br /> bout, C� g5713� <br /> Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMEN <br /> 9,11-1 <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 />