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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCI,TON, CA 95205 <br /> Phone: (209) 468-3420 <br /> /account lD AR0050483 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0026516 <br /> Date Printed 2/16/2023 <br /> WAHL, AMBER RE : WAHL TO WAHL CONFECTION'S <br /> WAHL TO WAHL CONFECTION'S 1620 CORBIN LN <br /> 1620 CORBIN LN LODI, CA 95242 <br /> LODI, CA 95242 <br /> OWNER : WAHL,AMBER L <br /> Date Health I <br /> Prograrr Degrription Amount <br /> Invoice# IN0377821 ---Date of Invoice : 2/16/2023 11111111 E$U 11111 1�111�1111 11111 Mil 11111 111 111�fli U1 111111 11111 1111 IN <br /> 2/16/2023 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0546820 $ 186.00 <br /> Total for this Invoice I $ 186.00 <br /> 130/2023 <br /> TOTAL DUE this Billing Period $ 18 .00 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOICE. <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 /> hgps•//www sigov.org/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-12ermittin <br /> g-renewal-form.pdf?sfvrsn=d950fb44_5 <https:Hp-cc02.safelinks.protection.outlook.com/? <br /> url=https%3A%2F%2Fwww sjgov.org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-permitting-renewal-form.pd %3Fsfvrsn%3Dd950fb44 5&data=05%7COI%7Cjsalwolke%40sjg <br /> ov.org%7COdO5 8e9dfbee4d8f10c308dab2233bdc%7C3 cfl''5075176a400d86Oa5496Oa7c7e5 l%7C0%7CO%7C63 801816164 <br /> 0113088%7CUnknown%7CTWF12bGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJOIjoiV2luMzIiLCJBTiI6Ik 1 haWwiLCJXVCI <br /> 6MnO%3D%7C3000%7C%7C%7C&sdata=6tRcKIyIC6hxT5tyga04bBY 12ImMj7b53zNcmtPtD%2FYTA%3D&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 /> PAYMENT <br /> RECEIVED <br /> i0 6 2022 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> Please make Checks PAYABLE to: 'EHD' HEALTH DEPARTMENT <br /> or <br /> Pay online at: 'https://www.s4gov.orq/departmentienvhealth/fees/online-fee-payment' <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 /> >I54.rpt ,i V 2,N End of report <br />