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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA <br /> <br /> 47099 <br /> INVOICE <br /> Facility ID FA0025069 <br /> Date Printed 2/21/2020 <br /> BILLBERRY, SHELLY RE : SHELLY'S SUGAR SHAK <br /> SHELLY'S SUGAR SHAK 1127 RUTLEDGE WAY <br /> 1127 RUTLEDGE WAY STOCKTON, CA 95207 <br /> STOCKTON, CA 95207 <br /> OWNER : BILLBERRY, SHELLY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0332798---Date of Invoice: 11/26/2019 �11111 E111 E 1111�1111�11 1$1111�11E 111111111111$111111hi IEIE IN <br /> 11/26/2019 1608 CLASS A COTTAGE FOOD-DIRECT SALES $ 155.00 <br /> Total for this Invoice $ 155.00 <br /> Payment Due Date 12/ 2019 <br /> TOTAL DUE this Billing Period $ 155.00 <br /> 1' <br /> F��gQiJIN CN <br /> ryoF4I"' <br /> NT <br /> DO-tF+(k�� <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 /> Nq�m <br />