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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 />LICENSE AND PERMIT <br />CALIBER COLLISION CENTERS <br />401 E CORPORATE DRIVE - SUITE 150 <br />LEWISVILLE, TX 75057 <br />Page 1 <br />Account ID <br />AR0042933 <br />Facility ID <br />FA0023321 <br />Date Printed <br />9/27/2019 <br />RE: CALIBER COLLISION CENTERS - <br />STOCKTON <br />3210 N WILSON WAY <br />STOCKTON, CA 95205 <br />OWNER: CALIBER COLLISION CENTERS <br />Date Health <br />Program Description Amount <br />Invoice # IN0329855 --- 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 TONSNR <br />9/26/2019 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />1111111 11111111111111 I I IMI 1111111111 � 1111111 I I I I I I <br />I I I I I I I I 1111111111111111 <br />$ <br />IE IN <br />347.00 <br />$ <br />30.00 <br />$ <br />249.00 <br />$ <br />49.00 <br />Total for this Invoice <br />$ <br />675.00 <br />Payment Due Date <br />10/27/2019 <br />$ <br />675.00 <br />TOTAL DUE this Billing Period <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 />