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SAN JOACIUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> COPYAccount ID AR0017934 <br /> INVOIC <br /> Facility ID FA0010934 <br /> LMMMMMMMMMMMA <br /> Date Printed 10/31/2017 <br /> STOCKTON MAZDA RE : STOCKTON MAZDA <br /> GENE LANGE 3003 AUTO CENTER CIR <br /> 3158 AUTO CENTER CIRCLE STE E STOCKTON, CA 95212 <br /> STOCKTON, CA 95212 <br /> OWNER : ZAMORA AUTOMOTIVE GROUP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0298478---Date ofInvoice: 9/26/2017 �1111111IIJIIII 1111111111111111111111111111111111111111111111IIHI IIIII IIII IIII <br /> 9/26/2017 1921 HMBP-Regular-Primary Location $ 381.00 <br /> 9/26/2017 1922 CERS Processing Fee $ 25.00 <br /> 9/26/2017 2220 SPA HW GEN<5 TONSNR $ 249.00 <br /> 9/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total forthis Invoice 1 $ 704.00 <br /> Payment Due Date 1 012 912 01 7 <br /> �0�® %��lu� TOTAL DUE this Billing Period $ 704.00 <br /> S� <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.mt <br />