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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0034013 <br /> INVOICE <br /> Facility ID FA0019100 <br /> Date Printed 10/31/2018 <br /> STOCKTON NISSAN RE : STOCKTON NISSAN <br /> PO BOX 691180 3077 E HAMMER LN <br /> STOCKTON, CA 95269-1180 STOCKTON, CA 95212 <br /> OWNER : LITHIA OF STOCKTON INC <br /> Date Health <br /> Program Descripticn Amount <br /> Invoice# IN0313995---Date of Invoice: 9/26/2018 11111 11111 11111 11111 11111 IN 111111 11111 1111 IN <br /> 9/26/2018 1921 HMBP-Regular-Primary Location $ 432.00 <br /> 9/26/2018 1922 CERS Processing Fee $ 30.00 <br /> 9/26/2018 2227 GEN 13<25 TONS PERMIT $ 1,949.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> 9/26/2018 APSA APSA SURCHARGE $ 26.00 <br /> Total for this Invoice $ 2,486.00 <br /> Payment Due Date 10/27/2018 <br /> TOTAL DUE this Billing Period $ 2,486.00 <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 /> 5?5-t.rpt <br />