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SAN JOAQUIN COUNTY <br /> ENVIRON;.ILENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E•HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0048264 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0025550 <br /> Date Printed 11/28/2023 <br /> BRESEE, MINDY RE : SIMPLY BREAD & MORE <br /> SIMPLY BREAD & MORE 1042 TULLOCH DR <br /> 1042 TULLOCH DR TRACY, CA 95304 <br /> TRACY, CA 95304 <br /> OWNER : BRESEE, MINDY <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0383233---Date of Invoice: 8/29/2023 11111111 EIIII III IIIII�IIII 11111 11111 11111 11111 11111 11111 11111 1111 111111 IEI IIII IIII <br /> 8/29/2023 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PR0544941 $ 486.00 <br /> Total for this Invoice I $ 486.00 <br /> Payment Due Date 9/30/2023 <br /> ATTENTION PAST DUE! <br /> YOUR HEALTH PERMIT Deliquent charges over <br /> FOR THE CURRENT YEAR 90 days! <br /> MAY NOT BE ISSUED UNTIL <br /> PAST DUE AMOUNTS ARE <br /> PAID IN FULL <br /> TOTAL DUE this Billing Period $ 486.00 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOI YO <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 /> littps://www.so2ov.org/departinent/eiiviiealtli/forms <br /> You can return by rnail to our department at the address on the top of your invoice or ernail completed forms and <br /> confirmation of payment to: jcastaneda c(e i2ov.ory-<mailto:jcastaneda&sir?ov.org> <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https://www.swoov.oraidepartmenVenyhealthlfees/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 /> 5254.rpt I Aid of report <br />