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ENVIRONMENTAL HEALTH DEPARTM' 7 Page 1 <br /> 600 E MAIN STREET <br /> STOCKTON, CA 95202 <br /> Phone: (209) 468-3420 co'opy <br /> INVOICE Account ID AR0002366 <br /> Facility ID FA0002805 <br /> Date Printed 10/7/2009 <br /> KAISER ROAD TRUST RE : PEARCE, JEFF H 39-40 <br /> 1680 INDIAN VALLEY RD 5125 S KAISER RD <br /> NOVATO, CA 94947 STOCKTON, CA 95215 <br /> OWNER : PEARCE, JEFF H <br /> Date Health <br /> Program Description Amount <br /> i <br /> Invoice# IN0191526---Date of Invoice: 6/23/2009 I IIIIIII IIIIII III IIIII IIIII IIIII IIIIIIIIII IIIII IIIIIIIIII IIII IIIIII IIIII IIII IIII <br /> Hrs Employee <br /> 5/4/2009 2765 335-REINSPECTION(actual time) 2.00 SANGALANG $ 210.00 <br /> 9/15/2009 9988 SERVICE CHARGE PENALTY $ 21.00 <br /> 10/7/2009 9999 PAYMENT ($ 210.00) <br /> Total for this Invoice $ 21.00 <br /> t I` N i� LT Y 0�I I I u G PAST DUE <br /> Invoice# IN0193647---Date of Invoice: 9/24/2009 (IIIIIII IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIIIIIIII IIII IIIIII IIIII IIII IIII <br /> Hrs Employee <br /> 8/13/2009 2765 R28-OCCUPANCY RE-INSPECTION 0.40 SANGALANG $ 46.00 <br /> Total for this Invoice $ 46.00 <br /> Payment Due Date 10/24/2009 <br /> TOTAL DUE this Billing Period $ 67.00 <br /> PAYMENT <br /> RECEIVED <br /> w 1 5 Z009 <br /> SAN JOAQUIN COUNn <br /> ENVIVIONMENTAL <br /> 9EWH DEPARTMENT <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 OES/HMMP 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 /> i�SA rnt <br />