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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 186'1!E HALELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0016932 <br /> <br /> <br /> Date Printed 12/31/2019 <br /> KOSTER,TERRY RE : TBT MOBILE TRUCK REPAIR <br /> T&T MOBILE TRUCK REPAIR 1001 W CHARTER WAY <br /> 1001 W CHARTER WAY STOCKTON, CA 95206 <br /> STOCKTON, CA 95206 <br /> OWNER : KOSTER,TERRY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0327278---Date of Invoice: 9/26/2019 1111111 11111 E 11111�1111 11E 111��E 1111111 U11 EM�111 11111�1E1 IP 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 TONSNR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 658.00 <br /> PAST DUE <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 /> ;2i4.rpt <br />