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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0051093 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0026794 <br /> Date Printed L 7/31/2023 <br /> KEMP-PADEN, URSULA RE : QUEEN B'S HERBAL TEAS & MORE <br /> QUEEN B'S HERBAL TEAS & MORE 1075 CARRIE ST <br /> 1075 CARRIE ST STOCKTON, CA 95206 <br /> STOCKTON, CA 95206 <br /> OWNER : KEMP-PADEN, URSULA <br /> Date Health <br /> Proaram Description Amuwil <br /> Invoice# IN0381956---Date of Invoice: 6/28/2023 I IIIIII IIIIII III VIII VIII VIII ILII VIII VIII VIII(IIII VIII IIII IIIIII VIII IIII IIII <br /> 6/28/2023 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0547213 $ 186.00 <br /> Total for this Invoice $ 186.00 <br /> Payment Due Date 7/30/2023 <br /> SECOND NOTICE /7� <br /> TOTAL DUE this Billing Period $ 186. 0 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOIC <br /> NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLLiDE A LABEL OF ONE OF YOUR <br /> CFO PRODUCTS. CFO RENEWAL FORM HERE: <br /> https•//www.s,jgov.orgZdocs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-12ermittin <br /> g-renewal-fonn.pdPsfvrsn=d950fb44 5 <https://gcc02.safelinks.protection.outlook.com/? <br /> url=https%3A%2F%2Fwww s,j2ov org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-pennitting-renewal-fonn.pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7C01%7Cjsalwolke%40sj>; <br /> ov.org%7C0d058e9dfbee4d8fl Oc308dab2233bdc%7C3cff5075176a400d860a54960a7c7e51%7C0%7C0%7C63801816164 <br /> 0113088%7CUnknown%7CTWF12bGZsb3d8eyJWljoiMC4wLjAwMDAiLCJOIjoiV2luMzliLCJBT1I6lklhaWwiLCJXVCI <br /> 6Mn0%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tyggQ4bBY 121mMj7b53zNcmtPtD%2FYTA%3D&reserved= <br /> peV KNIT <br /> You can return by mail to our department at to hCttti NIT the top of your invoice or email completed forms and <br /> RECEIVED <br /> AUG 14 2023 <br /> SAN JOAQUIN COUNTY 1 <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT �{- <br /> Please make Checks PAYABLE to: 'EHD' <br /> or �Y <br /> Pay online at: 'httt)s://www.sjgov.org/departmenVenvhealtlVfeeslonline-fee-payment' I n <br /> Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES ly <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 Fnd of report <br />