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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 AR0043460 <br /> INVOICE <br /> Facility ID FA0023549 <br /> Date Printed 7/3/2019 <br /> QUESADA, MARIA LUCRECIA RE : CRYSTAL ROSE CONFECTIONERY <br /> CRYSTAL ROSE CONFECTIONERY 3034 CELEBRATION DR <br /> 3034 CELEBRATION DR LODI, CA 95242 <br /> LODI, CA 95242 <br /> OWNER : QUESADA, MARIA LUCRECIA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0322779---Date of Invoice: 5/28/2019 IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 5/28/2019 1609 CLASS B COTTAGE FOOD-INDIRECT SALES $ 310.00 <br /> 7/3/2019 1608 CLASS A COTTAGE FOOD-DIRECT SALES $ 155.00 <br /> 7/15/2019 9997 CORRECTION TO A CHARGE ($ 310.00) <br /> Total for this Invoice $ 155.00 <br /> Payment Due Date 6/28/2019 <br /> TOTAL DUE this Billing Period $ 155.00 <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 /> .,:�,h VIVA 2S <br />