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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone:. X209) 468-3420 <br />Account I <br />INVOICE <br />Return This INVOICE with Your PAYMENT Facility ID <br />Date P nted <br /> <br /> <br /> <br /> <br />OWNER: GRENZ, KEVIN <br />Page 1 <br />AR0051527 <br />FA0026945 <br />1/17/2023 <br />Date Health <br />Program Description Amount <br />Invoice # IND376811 --- Date of Invoice : 12/12/2022 <br />12/12/2022 1608 CLASS A COTTAGE FOOD -DIRECT SALES <br />SECOND NOTICE <br />PR0547399 $ 186.00 <br />Total for this Invoice $ 186.00 <br />Payment Due Date 1/30/2023 <br />TOTAL DUE this Billing Period/ $ 186.00 <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 />https•//www sj2ov orWdocs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-permittin <br />g_ -renewal -form pdf?sfvrsn=d950fb44 5 <https://Pcc02.safelinks.protectioll.outlook.com/? <br />url=https%3 A%2 F%2Fwww.sjgov.org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br />urants%2Fcfo-registration-permitting-renewal-form pdfb/o3Fsfvrsn%3Dd950fb44 5&data=05%7C0I%7Cjsalwolke%40si <br />ov org/o7COd058e9dfbee4d8fl Oc308dab2233bdc%7C3cff5075176a400d860a54960a7c7e5 I%7C0%7C0%7C63801816164 <br />O 113088%7CUnknown%7CTWFpbGZsb3d8eyJ W IjoiMC4wLjAwMDAiLCJOIjoiV2luMzliLCJBTil6lk l haWwiLCJXVCI <br />6 M n0%3 D%7C3000%o7C%7C%7C&sdata=6tRcKMC6hxT5tvzg24 bBY 12lmMi 7b53zN cmtPtD%2FYTA%3 D&reserved= <br />0> <br />You can return by mail to our department at the address on the top ofyour invoice or email completed forms and <br />P�,� � 1/0,3 <br />Coy1F -4 IS 2-3�--;-10 y - <br />Please make Checks PAYABLE to: 'EHD' <br />or <br />Pay online at:'httos://www.siaov.ora/deoartment/envhealth/fees/online-fee-Davment' <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.rpl n r 91'3 `q For] of repo <br />