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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 /> Account ID AR0043000 <br /> INVOICE <br /> Facility ID FA0023345 <br /> Date Printed 2/13/2019 <br /> ACEVEDO, ROGELIO JR RE : ACEVEDO'S COLLISION, BODY& PAINT <br /> ACEVEDO'S COLLISION, BODY& PAINT 1107 S AURORA ST <br /> 1107 S AURORA ST STOCKTON, CA 95206 <br /> STOCKTON, CA 95206 <br /> OWNER : ACEVEDO, ROGELIO JR <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0315461 ---Date of Invoice: 9/26/2018 111111111111 H 11111 11111 11111 11111 11111 Ell 11111 fli�1111 1111 111111 1EI 1111 IN <br /> 9/26/2018 2220 SM HW GEN<5 TONS/YR $ 249.00 <br /> 9/26/2018 2399 UNIFIED PROGRAM FAC STATE SURCHARGE FEE $ 49.00 <br /> 12/15/2018 9994 PERMIT FEE PENALTY $ 249.00 <br /> Total for this Invoice $ 547.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 547.00 <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 /> �154.rpt <br />