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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 /> Account ID AR0017089 <br /> INVOICE <br /> Facility ID <br /> ed 10/31/2019 <br /> STOCKTON LOGISTICS LLC RE : STOCKTON LOGISTICS LLC <br /> TRACY ANN SARGENT 4199 E GIBRALTAR CT <br /> 160 CHAPEL RD STE 201 STOCKTON, CA 95206 <br /> MANCHESTER, NH 06042 <br /> OWNER : C & S WHOLESALE GROCERS <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0327339---Date of Invoice: 9/26/2019 1111111 EIII III 11111 1111 11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 11111 1111�111 <br /> 9/26/2019 1863 CalARP PROGRAM 3 FACILITY $ 826.00 <br /> 9/26/2019 1895 CalARP FAC STATE SURCHARGE FEE $ 270.00 <br /> 9/26/2019 1921 HMBP-Regular-Primary Location $ 534.00 <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 /> 9/26/2019 APSA APSA SURCHARGE $ 26.00 <br /> Totalfor Invoice $ 1,984.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 1,984.00 <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 />