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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA <br /> <br /> 551 <br /> INVOICE <br /> Facility ID FA0016306 <br /> Date Printed 11/27/2019 <br /> PHONPRADITH, SENGTHIP RE : TIPPY'S CAFE <br /> TIPPY'S CAFE 1330 E YOSEMITE AVE <br /> 1009 WINTERS DR MANTECA, CA 95336 <br /> MANTECA, CA 95337 <br /> OWNER : PHONPRADITH, SENGTHIP <br /> Date Health <br /> Program Description <br /> Amount <br /> Invoice# IN0325845---Date of Invoice: 9/25/2019 11111111 111111 III VIII IMI VIII VIII VIII VIII VIII VIII VIII IIII 11111111111 <br /> IIII IIII <br /> 9/25/2019 1612 FOOD EST<500 SQ FT W/O SEATING <br /> $ 350.00 <br /> Total forthis Invoice $ 350.00 <br /> Payment Due Date 10/27/2019 <br /> PAS,T D U E TOTAL DUE this Billing Period $ 350.00 <br /> WE tNOtJLD APPRECIATE YOUR <br /> PAYMENT TODAYI <br /> ill �V �2� <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 />