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AN JOAQUIN COUNTY �J <br /> Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT • S <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 pp�� <br /> Phone: (209) 468-3420 V <br /> INVOICE <br /> 30338 <br /> FacilityID FA001746mj <br /> -R CE Y Date Printed 9/27/2019 <br /> TRAILER PROZ oc 0 7 �- '`` PROZ <br /> IRSHAD ALI837 E ROTH RD <br /> PO BOX 1761 1�1�'IIZON�lC1VT`�Y 11L.f��T�� FRENCH CAMP, CA 95231 <br /> ELK GROVE, CA T5759 I)VIPAIZ�1�1L1��. <br /> OWNER : IRSHAD ALI <br /> Date Health A <br /> Piugram Description mount <br /> Invoice# IN0328873---Date of Invoice: 9/26/2019 /1111111 All 111111111►IIIA IIIA IIIA IIIA►ill11111111111►III illi <br /> 9/26/2019 1921 HMBP-Regular-Primary Location $ 381.00 <br /> 9/26/2019 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2019 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 709.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 709.00 <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 />