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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTM Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE AccountlD AR0039367 <br /> Facility ID FA0021698 <br /> Date PrintedL9/26/2013 <br /> � <br /> TOM MCCOY RE : OWENS BROCKWAY GLASS CONTAINER <br /> QUALITY SERVICE INC 14700 W SCHULTE RD <br /> 27348 E HWY 120 TRACY, CA 95377 <br /> ESCALON, CA 95320 <br /> OWNER : OI GLASS CONTAINER <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0238936---Date of Invoice: 3/8/2013 I IIIIIII VIII III IIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIII IIII IIII <br /> Hrs Employee <br /> 3/7/2013 2902 313-INSPECTION ACTIVITY 1.00 YOAKUM $ 125.00 <br /> 3/8/2013 9999 PAYMENT ($ 500.00) <br /> 4/23/2013 2902 314-INSPECTION ACTIVITY FINAL 6.50 YOAKUM $ 812.50 <br /> Total for this Invoice $ 437.50 <br /> PAST DUE <br /> 12 ' TOTAL DUE this Billing Period $ 437.50 <br /> x1 p i a <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt <br />