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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 AR0040205 <br /> INVOICE <br /> Facility ID FA0022042 <br /> Date Printed 9/27/2018 <br /> CHAPPELL, CYNTHIA RE : SWEET CINDYS GOODIES GALORE <br /> SWEET CINDYS GOODIES GALORE 140 S AVENA AVE <br /> 140 S AVENA AVE LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : CHAPPELL, CYNTHIA <br /> Date Health <br /> Program Description A muwuni <br /> Invoice# IN0311309---Date of Invoice: 9/26/2018 IIIIIII IIIIII III VIII VIII VIII(IIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 9/15/2018 9991 Credit Adjustment ($ 146.00) <br /> 9/26/2018 1608 CLASS A COTTAGE FOOD-DIRECT SALES $ 155.00 <br /> Total for this Invoice $ 9.00 <br /> Payment Due Date 10/27/2018 <br /> TOTAL DUE this Billing Period $ 9.00 <br /> PAYNIE Epkss-.Ub <br /> RECE�v r <br /> Q�W COUN U <br /> S FANTH pEPAR M NT � ��l <br /> H � <br /> `J <br /> S!n Q W i LC P1 4 g a a - P Lpa ._ <br /> P r►rvf- YLk "r Rk r vv-.+ of h-d q I V0- <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 />