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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMF"T <br />600 E MAIN STREET <br />STOCKTON, CA 95202 <br />Phone: (209) 468-3420 <br />INVOICE <br />PATRICK KELLY GENERAL MGR <br />TRACY CHEVROLET <br /> <br /> <br />Page 1 <br />COPY <br />Account ID <br />AR0017308 <br />Facility ID <br />FA0010308 <br />Date Printed <br />9/24/2010 <br />RE: TRACY CHEVROLET <br />3400 W AUTO PLAZA WAY <br />TRACY, CA 95376 <br />OWNER: Q & M INC <br />Date Health <br />Program Description Amount <br />Invoice # IN0206335 --- Date of Invoice : 8/24/2010 <br />H rs <br />7/13/2010 2227 306 - FOLLOW UP FOR NON-COMPLIANCE 0.50 <br />Invoice # IN0207202 --- Date of Invoice : 9/23/2010 <br />8/9/2010 2227 306 - FOLLOW UP FOR NON-COMPLIANCE <br />11111111 II!111 III 11!1111111111111!!11 !1111 IIII! 11111 III11 III! !1!111 !!!II III! 111! <br />Employee <br />RIVERA $ 5 <br />Total for this Invoice $ 57.50 <br />Payment Due Date (9/23/20 <br />111111111111111 ill 11111111111111111111111111111111 lillill 111111111111111 Hill 1111 IN <br />Hrs Employee <br />0.50 RIVERA $&61.00 <br />Total for this Invoice $Payment Due Date <br />TOTAL DUE this Billing Period $ 118.50 <br />PAYMENT <br />RECEIVED <br />OCT - 6 2010 <br />SA1EWR NMENT%� <br />HEpllr �EP4RTMEHT <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 thereafte <br />5254.rpt <br />