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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1862 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0039568 <br /> INVOICELUMMOMMOMMENME <br /> Facility ID FA0021770 <br /> Date Printed 11/19/2015 <br /> STEVENS, SCOTT RE : PREMIUM PLUMBING & DRAIN <br /> PREMIUM PLUMBING & DRAIN 2017 PATTERSON RD <br /> PO BOX 1426 RIVERBANK, CA 95367 <br /> LOS BANOS, CA 93635 <br /> OWNER : STEVENS, SCOTT <br /> Date Health <br /> -- _.__.__ Proaram Description Amount <br /> Invoice# IN0272302---Date of Invoice: 11/19/2015 IIIIIIIIIIII VIIVIIIIIIIIIIIIIIVIIIVIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIII <br /> 11/19/2015 4244 PUMPERTRUCK $ 158.00 <br /> Total forth is Invoice I $ 158.00 <br /> Payment Due Date 12/19/2015 <br /> TOTAL DUE this Billing Period $ 158.00 <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br /> _:4,pt <br />