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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL_ HEALTH DEPARTMENT <br /> Administrative Hearing Fee Payment Information <br /> Staff Use Only: <br /> Facility ID#: FA0006378PIR ID#: PR0528382 <br /> Account ID#: AR0007787 Invoice#: <br /> Facility Name: Blue Moon Tattoo/Piercing <br /> Facility Address: 2306 East Street, racy, CA 95376 <br /> Employee#: 9822 service Code: 106 <br /> Program Element;: 4121 Date of Hearinq: February 12, 2020 <br /> Accounting Use Only. <br /> Ppyment Date Fee Amount I Amount Paid Check#/Cash Rev'd B <br /> EHD 48-02-031 Admin Hearing Fee Pyrnt. <br /> 07/01/15 <br /> PAYMENT <br /> RECEIVED <br /> FEB 12 2020 <br /> SAN JOAQUIN COUNTY <br /> u ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br />