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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 /> Account ID AR0030620 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0017612 <br /> Date Printed 8/31/2023 <br /> PERMITS & LICENSING DEPT RE : AFC SUSHI @ SAFEWAY#2600 <br /> AFC SUSHI @ SAFEWAY#2600 1801 W ELEVENTH ST <br /> 19700 MARINER AVE TRACY, CA 95376 <br /> TORRANCE, CA 90503 <br /> OWNER : ADVANCED FRESH CONCEPTS FRANCHISE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0383428---Date of Invoice: 8/31/2023 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII IIIII IIII IIII <br /> 8/31/2023 1612 FOOD EST<500 SO FT W/O SEATING PR0526025 $ 350.00 <br /> Total for this Invoice $ 350.00 <br /> 9/30/2023 <br /> TOTAL DUE this Billing Period $ 350.00 <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https://www.sigov.ora/departmenVenvhealth/fees/online-fee-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 /> 5254.rp1 End of report <br />