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SAN JOAQUIN COUNTY <br />Page 1 <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />.1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Account ID AR0024503 III <br />INVOICE <br />Facility ID FA0014423 111 <br />Date Printed 11/16/2018 <br /> <br /> <br /> <br /> STOCKTON, CA 95205 <br />OWNER: MISTY BROWN <br />Date Health <br />Program Description Amount <br />Invoice # IN0312710 --- Date of Invoice : 9/26/2018 <br />9/26/2018 <br />1921 <br />HMBP-Regular-Primary Location <br />9/26/2018 <br />1922 <br />CERS Processing Fee <br />9/26/2018 <br />2220 <br />SM HW GEN <5 TONS/YR <br />9/26/2018 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII (IIII IIII <br />$ <br />IIIIII VIII IIII IIII <br />347.00 <br />$ <br />30.00 <br />$ <br />2.49.00 <br />$ <br />49.00 <br />Total for this Invoice $ 675.00 <br />Payment Due Date 10/27/2018 <br />TOTAL DUE this Billing Period $ 675.00 <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 thereafte <br />5254.rpt <br />