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SANJOAQJIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0050004 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0026320 <br /> Date Printed 12/14/2023 <br /> KOHL, KRISTA RE : SQUARES BAKE SHOP <br /> SQUARES BAKE SHOP 807 KINGERY DR <br /> 807 KINGERY DR RIPON, CA 95366 <br /> RIPON, CA 95366 <br /> OWNER : KOHL, KRISTA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0389360---Date of Invoice: 10/18/2023 11111 1111 111111 11111 IN IN <br /> 10/18/2023 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PR0546439 $ 486.00 <br /> Total for this Invoice $ 486.00 <br /> Payment Due Date 11/30/2023 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period fR <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVO C <br /> NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLUDE A LABEL OF ONE <br /> CFO PRODUCTS. CFO RENEWAL FORM HERE: <br /> https://www.sjgov.org/department/envhealth/fon-ns <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: jcastanedaCc,sigov.org<maiIto:jcastaneda a,sigov.org> <br /> V <br /> V <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'httns://www.siQov.orcildepartment/envhealth/fees/online-fee-Dayment' <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 I'nd ofreport <br />