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BILLING
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MOKELUMNE RIVER
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151
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1600 - Food Program
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PR0542487
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BILLING
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Entry Properties
Last modified
1/31/2023 4:32:12 PM
Creation date
12/8/2018 3:30:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0542487
PE
1608
FACILITY_ID
FA0024421
FACILITY_NAME
MY NANA'S COOKIES
STREET_NUMBER
151
STREET_NAME
MOKELUMNE RIVER
STREET_TYPE
DR
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
151 MOKELUMNE RIVER DR
P_LOCATION
02
QC Status
Approved
Scanner
SJGOV\jcastaneda
Supplemental fields
FilePath
\MIGRATIONS\M\MOKELUMNE\151\PR0542487\BILLING.PDF
Tags
EHD - Public
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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 to AR0045539 <br /> INVOICE <br /> Return This INV <br /> <br /> <br /> QUASHNICK, JULI A RE : MY NANA'S COOKIES <br /> MY NANA'S COOKIES 151 MOKELUMNE RIVER DR <br /> 151 MOKELUMNE RIVER DR LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : QUASHNICK, JULI A <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0376997—Date of Invoice: 12/1212022 ill III III VIII VIII(IIII VIII VIII VIII(IIII VIII VIII IIII IIII 11111 111 IIII <br /> 12/12/2022 1608 CLASS A COTTAGE FOOD-DIRECT SALES PRO542487 S 186.00 <br /> Totalfor[his Invoice $ 186.00 <br /> 1/ 12023 <br /> TOTAL DUE this Billing Period $ 6.00 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INV 1 E <br /> NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLUDE A LABEL OF ONE OF YOUR <br /> CFO PRODUCTS CFO RENEWAL FORM HERE: <br /> haps'//www sjgov org/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-pennittin <br /> g-renewal-form pdPsATsn=d950fb44 5<hUs7//jzccO2.safelinks.protection.outlook.com/? <br /> url=https%3A%2F%2Fwww si2ov org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-recta <br /> urants%2Fcfo-registration-permitting_renewal-form pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7C01%7Cisalwolke%40sie <br /> ov org%7C0d058e9dfbee4d8f10c308dab2233bdc%7C3cff5075176a400d860a54960a7c7e5l%7C0%7C0%7063801816164 <br /> 01130880/o7CUnknown%7CTWFpbGZsb3d8eyJWlioiMC4wLiAwMDAiLCJOlioi V2luMzIiLCJBTiI6ik 1 haWwiLCJXVCI <br /> 6Mn0%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tyggO4bBY12ImMi7b53zNcmtPtD%2FYTA%3D&reserved= <br /> 0> <br /> You can return by mail to our department at the address on the top of your invoice or email complete forms and <br /> RACE VED <br /> DEC ? 12022 <br /> SAN JOAQU/N COON <br /> HEALTH DEA NTAL <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https�//www.siaov.or hifees/online-fee-Dayment' <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 /> End of report <br />
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