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i <br /> Oriline Payments- LexisNexis Payment Solutions Page l of 2 <br /> (© SanJoaq=11Cou tty; Environmental <br /> !Health <br /> 1868 E. Hazelton Ave. <br /> Stockton CA 95205 <br /> (209)-468-3420 <br /> ' Payment Date 07/13/2020 04:22 PM PST Payment Status AUTHORIZED <br /> Confirmation Number 111042079 <br /> Payment Method Credit Card (VISA) ************2838 <br /> Expiration ##/## Transaction Type Purchase <br /> Approval Code 813122 <br /> AVS Response Y CVV2 Response M <br /> Bill To <br /> John Masellis <br /> 119 Albers Rd , Modesto, CA - 95357 US <br /> Payment Towards - <br /> Payment Towards Service Request Or Well Amount $640.00 <br /> Permit <br /> Site Address 15243 French Camp Rd Business Name Masellis Drilling, Inc. <br /> Ripon <br /> Phone Number 2095221928 <br /> Payment Towards Service Request Or Well Amount $152.00 <br /> Permit <br /> Site Address 15243 French Camp Rd Business Name Masellis Drilling, Inc. <br /> Ripon <br /> I� Phone Number 2095221928 <br /> Charge Information - --- -- <br /> Agency Amount $792.00 <br /> LexisNexis Service Fee $18.14 <br /> Total Amount $810.14 <br /> Your payment was made through paymentsolutions.lexisnexis.com, one of the LexisNexis VitalChek Network Inc. portals. <br /> For business or technical support, please send an email to paymentsolutions@lexisnexis.com. <br /> For San Joaquin County Environmental Health support, please call (209)468-3420 <br /> https:Hpayments.lexisnexis.com/billingInfoConf.xhtml 7/13/2020 <br />