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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />CALIBER COLLISION CENTER <br />401 E CORPORATE DRIVE - SUITE 150 <br />LEWISVILLE, TX 75057 <br />Page 1 <br />Account ID <br />AR0038054 <br />Facility ID <br />FA0021115 <br />Date Printed <br />9/27/2019 <br />RE: CALIBER COLLISION CENTERS - MANTECA <br />17890 IDEAL PKWY <br />MANTECA, CA 95336 <br />OWNER: CALIBER COLLISION CENTER <br />Date Health <br />Program Description Amount <br />Invoice # IN0329454 --- Date of Invoice: 9/26/2019 <br />9/26/2019 <br />1921 <br />HMBP-Regular-Primary Location <br />9/26/2019 <br />1922 <br />CERS Processing Fee <br />9/26/2019 <br />2220 <br />SM HW GEN <5 TONS/YR <br />9/26/2019 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />1I11II11111II 111 IIII11111I 11111 IIII1 IIIII IIIII IIIII 1111111111 IN <br />$ <br />111111111111111 IN <br />330.00 <br />$ <br />30.00 <br />$ <br />249.00 <br />$ <br />49.00 <br />Total for this Invoice $ 658.00 <br />Payment Due Date 10/27/2019 <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 />5254. rpt <br />