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Account ID AR0051298 Facility ID FA0026860 Date Printed 12/6/2023 INVOICE Return This INVOICE with Your PAYMENT I 111111110111111111111111 11111111111111 PRO547290 1 11111 VIII 1101 1111 111111 HID 1111 II II 186.00 Is nvoice Payment Due Date 186.00 10/30/2023 186.00 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Photie: (209) 468-3420 Page 1 ELLIOTT, CLINT RE: MR WINTEAS MR WINTEAS 23346 S FREDERICK RD 23346 S FREDERICK RD RIPON, CA 95366 RIPON, CA 95366 OWNER: ELLIOTT, CLINT W Date Health Program Description Amount Invoice # IN0388150 --- Date of Invoice : 9/28/2023 9/28/2023 1608 CLASS A COTTAGE FOOD-DIRECT SALES ATTENTION YOUR HEALTH PERMIT FOR THE CURRENT YEAR MAY NOT BE ISSUED UNTIL PAST DUE AMOUNTS ARE PAID IN FULL PAST DUE! WE WOULD APPRECIATE YOUR PAYMENT TODAY! TOTAL DUE this Billing Periodl ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOICE. vU NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLUDE A LABEL OF ONE OF YOUR CFO PRODUCTS. CFO RENEWAL FORM HERE: https://www.sjgov.org/departmentienvhealth/forms You can return by mail to our department at the address on the top of your invoice or email completed forms and confirmation of payment to: jcastaneda@sigov.org <mailto:jcastanedagsjgov.org> Please make Checks PAYABLE to: 'EHD' or Pay online at: littos://www.sjgov.org/department/envhealth/fees/online-fee-payment' Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES 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% 30 Days after the Due Date 60 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter 5254.rpt End of report