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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0048860 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0025827 <br /> Date Printed 5/16/2023 <br /> SHAFER, BRENDA RE : KNEADS PROOF / <br /> KNEADS PROOF 835 S CHURCH ST V/ <br /> 835 S CHURCH ST LODI, CA 95240 <br /> LODI, CA 95240 <br /> OWNER : SHAFER, BRENDA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0377817---Date of Invoice: 2/16/2023 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII IIIII IIIII IIII IIIIII VIII IIII IIII <br /> 2/16/2023 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0545498 $ 186.00 <br /> Total for -Invoice $ 186.00 <br /> Payment Due Date 3/30/2023 <br /> ATTENTION PAST DUE! <br /> YOUR HEALTH PERMIT WE WOULD APPRECIATE YOUR <br /> PAYMENT TODAY! <br /> FOR THE CURRENT YEAR <br /> MAY NOT BE ISSUED UNTIL <br /> PAST DUE AMOUNTS ARE <br /> PAID IN FULL <br /> TOTAL DUE this Billing Period Ej$ 186.00 <br /> ATTENTION! Y UR F PERMIT WILLNOTBE RENEWED BY NLY PAYING THE I V . <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 sigov ororgJdocs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-permittin <br /> g-renewal-form pdPsfvrsn=d950fb44 5 <https:H2cc02.safeIinks.protection.outlook.com/? <br /> tirl=https%3A%2F%2Fwww sigov org%2Fdocs%2Fdefault-source%2Fenvirontnental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-permitting;-renewal-form pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7C01%7Cisalwolke%40si <br /> ov.ora%7COdO58e9dfbee4d8fl Oc308dab2233bdc%7C3cff5075176a400d86Oa5496Oa7c7e51%7C0%7CO%7C63801816164 <br /> 0113088%7CUnknown%7CTWFpbGZsb3d8e1 JWIjoiMC4wLjAwMDAiLCJOIjoiV2luMZIiLCJBTi16Ikl haWwiLCJXVCI <br /> 6MnO%3D%70000%7C%7C%7C&sdata=6tRcKMC6hxT5tyga04bBY 121mMj7b53zNcmtPtD%2FYTA%3 D&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 /> rcl';� 1 5//z � 3 <br />