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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTN f <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />GERARD VAN EGMOND IRV TRST1997 <br />VAN EGMOND, G C (GREENDALE) <br />PO BOX 580 <br />GALT, CA 95632 <br />Page 1 <br />Account ID <br />AR0002987 <br />Facility ID <br />FA0003410 <br />Date Printed <br />2/20/2014 <br />RE: VAN EGMOND, G C (GREENDALE) <br />8220 E LIBERTY RD <br />GALT, CA 95632 <br />OWNER: VAN EGMOND,GERARD IRV TRST1997 <br />Date Health <br />Program Description Amount J <br />Invoice # IN0247219 ---Date of Invoice: 1/30/2014 <br />1/30/2014 1958 HM -Farm Operations <br />1/30/2014 2220 SM HW GEN <5 TONSNR <br />1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VII I IIII <br />$ <br />IIIIII VIII IIII IIII <br />18.00 <br />$ <br />213.00 <br />$ <br />35.00 <br />Total for this Invoice $ <br />266.00 <br />Payment Due Date <br />3/1/2014 <br />$ <br />266.00 <br />TOTAL DUE this Billing Periodl <br />Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT <br />'enalties 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 thereafter <br />5254. rpt <br />