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SAN JOAQUIN COUNTY <br /> ENVIRONMENTALH'EALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> COPYAccount ID AR0003144 <br /> INVOICE <br /> Facility ID FA0003565 <br /> Date Printed 9/27/2019 <br /> UNIVERSAL SWEEPING SERVICES RE : UNIVERSAL SWEEPINGS SERVICES <br /> JOE VELLA 1113 SHAW RD <br /> PO BOX 28010 STOCKTON, CA 95215 <br /> SAN JOSE, CA 95159 <br /> OWNER : JOE VELLA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0326318---Date of Invoice: 9/26/2019 11111 11111 11111 11111 IN IIIIII IIIII IIII IIII <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 TONSNR $ 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 /> Total for this Invoice 1 $ 888.00 <br /> Payment Due Date 10/27/2019 <br /> TOTAL DUE this Billing Period $ 888.00 <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 /> S�Sd mt <br />