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SAV -JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 F HAZELTON AVENUE <br /> ` STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR004 <br /> <br /> <br /> DatePnnted 11/28/2022 <br /> DUENAS LATICIA RE : GIRL VS GARDEN <br /> GIRL VS GARDEN 1529 PIONEER ST <br /> 1529 PIONEER ST ESCALON, CA 95320 <br /> ESCALON, CA 95320 <br /> OWNER : DUENAS LATICIA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0374212---Date of Invoice: 9/2912022 11111111111111111111IEII11111111111111111111111 <br /> 9/29/2022 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PR0544989 $ 312.00 <br /> 11/15/2022 9997 CORRECTION TO A CHARGE PR0544989 ($ 312.00) <br /> 11/28/2022 1608 CLASS A COTTAGE FOOD-DIRECT SALES $ 186.00 <br /> Total forthis Invoice I $ 186.00 <br /> 413012Q22 <br /> TOTAL DUE this Billing Period $ 186.00 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOICE. YOU <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.s i pov.oriz/docs/default-source/env ironmeiital-health-documents/food-and-restaurants/cfo-registration-perm itt i n <br /> P-renewal-form.pdflsfvrsn=d950tb44 5 <hilps:Hpcc02.safelinks.protection.outlook.com/? <br /> url=https%3 A%2F%2Fwww.sigov.org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-recta <br /> urants%2Fcfo-registration-permitting-renewal-form.pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7C0I%7C4salwolke%40si9 <br /> ov.ory%7C0d058e9dfbee4d8fIOc308dab2233bdc%7C3cff5075176a400d86Oa5496Oa7c7e5l%7CO%7CO%7063801816164 <br /> 01 13088o/o7CUnknown%7CTWFpbGZsb3d8eyJ W lioiMC4wLiAwMDAiLCJOlioi V2lu Mzl iLCJBTiI6Ik 1 ha WwiLCJX VC I <br /> 6MnO%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tygg04bBY 12lmMi7b53zNcmtPtD%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 completed forms and <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'htti)s://www.sigov.ora/depattmenVenvhealth/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 100/ Penalties will be added at the Rate of 10% <br /> 30 Days after the Due Date 60 Days after the Invoice Date {t 160 Days after the Invoice Date and each 30 Days thereafter <br /> 5254.rpt Dr,n oglgqy End of report <br />