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5AN JOAQUIN COUNTY <br /> ENVIRC)NMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 9520 <br /> <br /> R0047119 <br /> INVOICE <br /> Facility ID FA0025084 <br /> Date Printed 12/31/2019 <br /> RUSSELL, RAY RE : R&B ORIGINAL <br /> R&B ORIGINAL 844 W LONGVIEW AVE <br /> 844 W LONGVIEW AVE STOCKTON, CA 95207 <br /> STOCKTON, CA 95207 <br /> OWNER : RUSSELL, RAY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0333357---Date of Invoice: 12/30/2019 11111111 111111 III IIID VIII VIII VIII VIII VIII VIII VIII VIII IIII 11111111111 <br /> IIII IIII <br /> 12/30/2019 1609 CLASS B COTTAGE FOOD-INDIRECT SALES $ 310.00 <br /> Total forthis Invoice $ 310.00 <br /> Payment Due Date 1/30/2020 <br /> TOTAL DUE this Billing Period $ 310.00 <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 />