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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 />PAIGE GILLIN <br />PROFLEET TRUCK LUBE ACAMPO <br />24511 N HWY 99 <br />ACAMPO, CA 95220 <br />Page 1 <br />Account ID <br />IAR0047669 <br />Facility ID <br />FA0025324 <br />Date Printed <br />1 6/7/ 2019 <br />RE: PROFLEET TRUCK LUBE ACAMPO <br />24511 N HWY 99 <br />ACAMPO, CA 95220 <br />OWNER: GILLIN, PAIGE <br />Date Health <br />Program Description <br />Amount <br />Invoice # IN0323135 --- Date of Invoice : 6/7/2019 <br />6/7/2019 <br />1921 <br />HMBP-Regular-Primary Location <br />6/7/2019 <br />1922 <br />CERS Processing Fee <br />6/7/2019 <br />2220 <br />SM HW GEN <5 TONS/YR <br />6/7/2019 <br />2399 <br />UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />6/7/2019 <br />APSA <br />APSA SURCHARGE <br />1II1II11II1II 111 IMI I1I11111II 1111111111 I1III 1111111111 IIIII 111111111111111 <br />$ <br />IN IN <br />364.00 <br />$ <br />30.00 <br />$ <br />249.00 <br />$ <br />49.00 <br />$ <br />26.00 <br />Total for this Invoice $ 718.00 <br />Payment Due Date 7/7/2019 <br />TOTAL DUE this Billing Period $ 718.00 <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 />52>4.rpt <br />