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SAN JOAQUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> INVOICE Account ID AR0000639 <br /> Facility ID E FA00LLJ <br /> Date Printed 1 12/22/2014 <br /> VAN VLIET VENTURES INC RE : A-1 SEPTIC SERVICE <br /> A-1 SEPTIC SERVICE 6613 WOODLAND AVE <br /> 6613 WOODLAND AVE MODESTO, CA 95358-8502 <br /> MODESTO, CA 95358-8502 <br /> OWNER : VAN VLIET, HUGO <br /> Date Health <br /> -- -- Program Description Amount- _I <br /> Invoice# IN0257956---Date of Invoice: 11/19/2014 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII III�I IIIIIIIIIII111INIIEIIIIIIININ <br /> 11/19/2014 4244 PUMPER TRUCK $ 158.00 <br /> 11/19/2014 4244 PUMPER TRUCK $ 158.00 <br /> Total for this Invoice $ 316.00 <br /> Payment Due Date 12/20/2014 <br /> •� TOTAL DUE this Billing Period $ 316.00 <br /> RF�F�NT <br /> D <br /> JAAf,?8 5 <br /> H���pE SNT���7Y <br /> QWAI <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 />