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SAN/JOAQUIN COUNTY <br /> E ''IRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 2868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID 7R0030180 <br /> INVOICE <br /> Facility ID FA0017298 <br /> Date Printed 10/31/2017 <br /> RE : BILL MARTIN <br /> BILL MARTIN 29411 E LEMON <br /> 29411 E LEMON ESCALON, CA 95320 <br /> ESCALON, CA 95320 <br /> OWNER : BILL MARTIN <br /> nate Health <br /> grogramDe.,rilptloo ".m. cunt <br /> Invoice# IN0299577---Date of Invoice: 9/26/2017 11I111IVI VIII VIII VIVVI VIM/III 11111111111 III/I'll <br /> 9/26/2017 1922 CERS Processing Fee $ 25.00 <br /> 9/26/2017 1958 HM-Farm Operations $ 22.00 <br /> 9/26/2017 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> Total for this Invoice $ 96.00 <br /> Payment Due Date 1012912017 <br /> TOTAL DUE this Billing Period $ 96.00 <br /> �Oil IIN� <br /> �. <br /> PAYMENT <br /> RECEIVED <br /> NOV 17 2017 �- <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMHEALTH 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 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 /> 5254rpt <br />