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SAN JOAQUIN COUNTY <br /> tNVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0009076 <br /> INVOICE ` <br /> Facility ID FA0006696 <br /> Date Printed 11/27/2019 <br /> CALIFORNIA ARMY GUARD MILITARY RE : STOCKTON CSMS <br /> DEPARTMENT 8020 S AIRPORT WAY <br /> 10620 MATHER ROAD (ATTN: ANN CONERLY) STOCKTON, CA 95206 <br /> MATHER, CA 95655 <br /> OWNER : CALIFORNIA ARMY GUARD MILITARY DEPAF <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0326817 •--Date of Invoice: 9/26/2019 I(IIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII(IIII(IIII VIII IIII IIIIII VIII IIII IIII <br /> 9/26/2019 1921 HMBP-Regular-Primary Location n $ II 687.00 <br /> 9/26/2019 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2019 2,220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2019 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 1,015.00 <br /> I <br /> Payment Due Date 10/27/2019 { <br /> PAST DUE! TOTAL DUE this Billing Period $ 1,015.00 <br /> WE WOULD APPRECIATE YOUR <br /> PAYMENT TODAYI <br /> Pleas: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 /> 525d.rpt <br />