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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> <br /> <br /> Account ID AR0046050 <br /> INVOICE <br /> Facility ID FA0024636 <br /> Date Printed 1 7/26/2019 <br /> DAVALOS, GYNAE RE : SUGA RUSHD <br /> SUGA RUSHD 10940 WILDBERRY LN <br /> 10940 WILDBERRY LN STOCKTON, CA 95209 <br /> STOCKTON, CA 95209 <br /> OWNER : DAVALOS, GYNAE <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0320480---Date of Invoice: 3/25/2019 11111 11111 11111 NII IIIII IIIII IIIII IIIII IIIII 1111 111111 11111 1111 IN <br /> 3/25/2019 1608 CLASS A COTTAGE FOOD-DIRECT SALES $ 155.00 <br /> 6/15/2019 9994 PERMIT FEE PENALTY $ 155.00 <br /> Total for this Invoice $ 310.00 <br /> PAST DUE <br /> TOTAL DUE this Billing Period $ 310.00 <br /> DU ! <br /> "'RECIWE YOUR <br /> PAYMENT OCAY� <br /> ATTENTION <br /> YOUR HEALTH PERMIT FOR <br /> THE CURRENT YEAR <br /> WILL NOT RE ISSUED UNTIL <br /> PAST DUE AMOUNTS <br /> ARE PND IN FULL <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 /> 5254.rpt <br />