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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) 468-342 <br /> <br /> INVOICE <br /> Facility ID FA0021115 <br /> Date Printed 9/27/2019 <br /> CALIBER COLLISION CENTER RE : CALIBER COLLISION CENTERS - MANTECA <br /> 401 E CORPORATE DRIVE -SUITE 150 17890 IDEAL PKWY <br /> LEWISVILLE, TX 75057 MANTECA, CA 95336 <br /> OWNER : CALIBER COLLISION CENTER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0329454---Date of Invoice: 9/26/2019 11111 11111 11111 11111 11111 IN 111111 11111 1111 IN <br /> 9/26/2019 1921 HMBP-Regular-Primary Location $ 330.00 <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 $ 658.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 658.00 <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 />