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7/13/2017 Official Payments - Pay Taxes, Utility Bills, Tuition & Online <br />This is a "printer friendly" page. Please use the "print" option in your browser to print this screen. <br />OFFICIAL <br />MI PAYMENTS' <br />San Joaquin County - Environmental Health Department, CA <br />Environmental Health Fees <br />Confirmation Number: 013369 <br />Payment Date: Thursday, July 13, 2017 <br />Payment Time: 02:35PM PT <br />Payer Information <br />Name: Ana Lua <br />Street Address: 17278 Golden Valley Parkway <br />Lathrop, CA 95330 <br />United States <br />Daytime Phone <br />Number: <br />E-mail Address: <br />(209) 684 - 7604 <br />alua@engeo.com <br />Please provide as much information as possible below so that we may identify your payment: <br />Address of Facility <br />where work is being 16476 Cohen Road <br />done: <br />Buisness Name: ENGEO Inc. <br />Invoice Number: 5044.411.104 <br />Additional Information: For well permit <br />Card Information <br />Card Type: Visa <br />Card Number: .*******...0527 <br />Payment Information <br />Payment Type: Environmental Health Fees <br />Payment Amount: $139.00 <br />Convenience Fee: $10.95 <br />Total Payment: $149.95 <br />Thank you for using Official Payments. If you have a question regarding your payment, please call us toll free at <br />1-800-487-4567. To make payments in the future, please visit our website at www.officialpayments.com. <br />NC= <br />Copyright 0 2017 Official Payments Corporation. All Rights Reserved. <br />Official Payments Corporation is a licensed money transmitter in 44 states, the District of Columbia, and Puerto Rico. <br />Official Payments is not required to be licensed as a money transmitter in Indiana, Massachusetts, Montana, New Mexico, <br />South Carolina or Wisconsin. <br />https://www.officialpayments.com/pc_step6_print.jsp 1/1