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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 FA0025096 <br /> Date Printed 1/14/2020 <br /> MACIAS-CAMPOS, DAVID III RE : EL NENE'S WONDER COOKIES <br /> EL NENE'S WONDER COOKIES 166 HALLER CT <br /> 166 HALLER CT RIPON, CA 95366 <br /> RIPON, CA 95366 <br /> OWNER : MACIAS-CAMPOS, DAVID III <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0333358---Date of Invoice: 12/30/2019 111111111111 H 11111 11111 11111 11111 11M 11M 11111 N11 11h 1111 111111 Ifil IE IN <br /> 12/30/2019 1609 CLASS B COTTAGE FOOD-INDIRECT SALES $ 310.00 <br /> Total for this Invoice $ 310.00 <br /> Payment Due Date 1/30 020 <br /> TOTAL DUE this Billing Period $ 310.00 <br /> PA <br /> SgNJOj� 20? <br /> Ely O�gQi.// <br /> NSC HI RONMFCOUNn' <br /> OCpARTAfeNT <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.rht V"591135 <br />