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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 /> INVOICE AccountID AR0025636 <br /> Facility ID FA00150 0— <br /> Date Pnntetl 3/28/2013 <br /> LODI GRADING& PAVING INC RE : LODI GRADING& PAVING INC <br /> <br /> LODI, CA 95240 <br /> OWNER : MICHAEL R JENNINGS <br /> —Health <br /> Date Program Description Amount <br /> Invoice# IN0236900--Date of Invoice: 21112013 III III 1111111111111111111 IN <br /> 2/1/2013 1921 HMBP-Regular-Primary Location $ 315.00 <br /> 2/1/2013 2220 SM HW GEN<5 TONSNR $ 213.00 <br /> 2/1/2013 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> Total for this Invoice $ 563.00 <br /> Payment Due Date 3/312013 <br /> TOTAL DUE this Billing Period $ 563.00 <br /> r' r <br /> 0 <br /> QVZ C 05 <br /> A .� G Int'4�& bl APR O <br /> � K$. KH$.S 42 i't5 �4NJ / FNlq�p 80/3 <br /> We 4D tncl �la'v� 6(,ty W%bKey to �at� 't� vtty pf9MT A�� ITy <br /> ps aws;n4-ss / 6c ab"'c�l� <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 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days the <br /> 5254 rpt <br />