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-SAN JCAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> V Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 ° <br /> Phone: (209)468-3420 "`—"ft <br /> INVOICE FEB j 9 2014 AwountID AROo29869 <br /> ENVIltow ENT HEALTH <br /> PERMIT/SERVICE$ Fauliry ID I FA0016987 <br /> LUMENEENNINNEENNEM <br /> Date Printed 1/30/2014 <br /> J DELCARLO FARMS RE : J DELCARLO FARMS <br /> 835 W MARIPOSA AVE 11751 SWING LEVEE RD <br /> STOCKTON, CA 95204 STOCKTON, CA 95206 <br /> OWNER : J DELCARLO FARMS <br /> Dale Hea„h <br /> Program Description Amount <br /> Invoice# IN0249406—Date of Invoice: 1130/2014 pp1Hill p1111111pp1pp11pp11Hill p111p1 <br /> 1/30/2014 1958 HM-Farm Operations $ 18.00 <br /> 1/30/2014 2220 SM HW GEN<5 TONS/YR $ 213.00 <br /> 1/30/2014 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 35.00 <br /> TOUl for this Invoice $ 266.00 <br /> Payment Due Date 3/1/2014 <br /> TOTAL DUE this Billing Period $ 266.00 <br /> As AU� a) 1 3 v) e n/o ,fir Loll,?e <br /> T►-wt +t�l s P fo p tr- gYMF <br /> FI T <br /> �J F � <br /> s'8 !y <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 thereafter <br /> 5254 rpt <br />