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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM Page 2 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0027044 <br /> INVOICE <br /> Facility ID FA0015640 <br /> Date Printed 10/6/2015 <br /> AHMED,AMIR RE : AHMED, AMIR <br /> 4868 IJAMS RD 2156 S B ST <br /> STOCKTON, CA 95210 STOCKTON, CA 95206 <br /> OWNER : AHMED,AMIR <br /> Date Health <br /> Program Description Amount <br /> Total for this Invoice I $ 117.00 <br /> PAST DUE <br /> Invoice# IN0265907---Date of Invoice: 4/30/2015 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> Hrs Employee <br /> 3/4/2015 1322 C54-Office-Case Review, Permit Check 0.50 VELOSO $ 65.00 <br /> 3/4/2015 1322 P54-Office-Phone,Counter Consultation 0.10 VELOSO $ 13.00 <br /> Total for this Invoice $ 78.00 <br /> PAST DUE <br /> Invoice# IN0267593---Date of Invoice: 6/10/2015 11111111 IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 6/10/2015 1321 Enforcement Activity Charges $ 271.50 <br /> Total for this Invoice $ 271.50 <br /> PAST DUE <br /> TOTAL DUE this Billing Periodl $ 2,300.44 <br /> NOTE: Afterallviolations have been correctedandall <br /> outstanding enforcement costs have been paid, a release of <br /> IN of Violation"will be submitted to the San Joaquin <br /> County Recorder's Office, if applicable. <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 <br /> at the Rate of 100%of the Base Fee Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 45 Days after the Invoice Date <br /> 5254.rpt <br />