Laserfiche WebLink
SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1866 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Page 1 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br />Account ID <br />Facility ID <br />Date Printed <br />AR0048666 <br />FA0025725 <br />12/27/2022 II <br />BURNLEY, JESSICA <br />ROGUE BREAD <br />1510 EASTLAKE CIR <br />TRACY, CA 95304 <br />RE: ROGUE BREAD <br />1510 EASTLAKE CIR <br />TRACY, CA 95304 <br />OWNER: BURNLEY, JESSICA <br />Date Health <br />Program Description Amount <br />Invoice # IN0376819 --- Date of Invoice: 12/12/2022 <br /> <br />111111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />12/12/2022 1609 CLASS B COTTAGE FOOD-INDIRECT SALES <br /> PRO545238 312.00 <br />Total for this Invoice <br />Payment Due Date 1/30/2023 <br />TOTAL DUE this Billing Period $ 312.00 <br /> <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 />https://www.sjgov.org/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-permittin <br />g-renewal-form.pdf?sfvrsn=d950fb44_5 <https://gcc02.safelinks.protection.outlook.com/? <br />url=https%3A%2F%2Fwww.sjgov.org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br />urants%2Fcfo-registration-permitting-renewal-form.pdf%3Fsfvrsn%3Dd950fb44_5&data=05%7C01%7Cjsalwolke%40sjg <br />ov.org%7C0d058e9dfbee4d8f10c308dab2233bdc%7C3cff5075176a400d860a54960a7c7e51%7C0%7C0%7C63801816164 <br />0113088%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAILCJQIj01V2IuMzIiLCJBTII6Ik1haWwiLCJXVCI <br />6Mn0%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tygqQ4bBY12ImMj7b53zN cmtPtD%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 />Poi nt 11 31 2_ 7277 z <br />Co P4t I F q (9 7 °I (17 1 <br />Please make Checks PAYABLE to: 'EHD' <br />or <br />Pay online at: *https://www.sjgov.oru/deriartment/envhealth/feesionline-fee-Dayment' <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% <br /> 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 />312.00 <br />5254.rpt End of report