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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 FaciI4ID FA0025827 <br /> Date Printed 2/28/2024 <br /> SHAFER, BRENDA RE : KNEADS PROOF <br /> KNEADS PROOF 835 S CHURCH ST <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# IN0391595---Date of Invoice: 2/9/2024 11111111 E111 h 11111 11111 111 1111 11111 11111 111 11111 1111 1111 111111 11111 1111 IN <br /> 2/9/2024 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0545498 $ 186.00 <br /> Total for this Invoice $ _486:00 <br /> 3/301202 4 <br /> TOTAL DUE this Billing Period j$___186.00.) <br /> ATTENTION! YOUR CFO PERMIT WILL NOTBE RENEWED BY ONLY PAYING THE IN <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.s-gitov.orp-/del2artment/envhealth/forms <br /> You can return by mail to our department at the address on the top of your invoice or email completed forms and <br /> confirmation of payment to: jcastanedana sj ov.org, <mailto:jcastaneda cr si To, v.or <br /> RFS MENT <br /> E/QED <br /> FEB 2 8 2024 <br /> SAN <br /> Oq QUI <br /> H�gLTHRp P ER�T1' <br /> NT <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'htti)s://www.sjgov.orQ/department/envhealttyfees/online-fee-paayment' <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 End of report <br />