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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 9520 <br /> <br /> <br /> INVOICE <br /> Facility ID FA0016306 <br /> Date Printed 10/31/2019 <br /> PHONPRADITH, SENGTHIP RE : TIPPY'S CAFE <br /> TIPPY'S CAFE 1330 E YOSEMITE AVE <br /> 1330 E YOSEMITE AVE MANTECA, CA 95336 <br /> MANTECA, CA 95336 <br /> OWNER : PHONPRADITH, SENGTHIP <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0325845---Date of Invoice: 9/25/2019 11111111 E111 H 11111 11111 11111 11111 11111 11111 11111 11111 11111 1111 111111 11111 1111 IN <br /> 9/25/2019 1612 FOOD EST<500 SQ FT W/O SEATING $ 350.00 <br /> Total for this Invoice $ 350.00 <br /> Payment Due Date 10/27/2019 <br /> SECONDNOTICE TOTAL DUE this Billing Period $ 350.00 <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 />