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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Page 1 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Phone: (209)468-3420 Account ID AR0000994 INVOICE Return This INVOICE with Your PAYMENT Facility ID FA0000997 Date Printed 4/26/2021 BIG LOTS LODI 4106 RE : BIG LOTS LODI 4106 TAX DEPT 380 S CHEROKEE LN 4900 E DUBLIN GRANVILLE RD LODI, CA 95240 COLUMBUS, OH 43081 OWNER : PNS STORES INC Date Health Program Description Amount Invoice# IN0349098---Date of Invoice: 2/25/2021 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII Hrs Employee 1/4/2021 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.40 FLORIDO $ 60.80 1/21/2021 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.50 FLORIDO $ 76.00 1/26/2021 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.10 FLORIDO $ 15.20 Total for this Invoice $ 152.00 Payment Due Date 3/30/2021 Invoice# IN0349625---Date of Invoice: 3/25/2021 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII Hrs Employee 2/12/2021 2220 306-FOLLOW UP FOR NON-COMPLIANCE 0.20 FLORIDO $ 30.40 Total forthis Invoice $ 30.40 Payment Due Date 4/30/2021 SECOND NOTICE Invoice# IN0351397---Date of Invoice: 4/22/2021 I IIIIIII IIIIII III VIII VIII VIII(IIII VIII VIII VIII VIII VIII IIII IIIIII IIIII IIII IIII 4/22/2021 1615 RETAIL MKT 301-2000 SQ FT(PREPKGD/LTD PREP) $ 250.00 Total for this Invoice $ 250.00 Payment Due Date 5/30/2021 TOTAL DUE this Billing Period $ 432.40 Please make Checks PAYABLE to: 'EHD' or Pay online at: 'https://www.sjgov.orci/department/envhealth/online-payment' Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES 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% 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter 5254.rpt End of report