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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 AR0051616 <br /> <br /> <br /> 1!31/2023 <br /> MARTINEZ,ADRIANA RE : ADRI'S COOKIE CO <br /> ADRI'S COOKIE CO 2325 OREGON AVE <br /> 2325 OREGON AVE STOCKTON,CA 95204 <br /> STOCKTON,CA 95204 <br /> OWNER : MARTINEZ,ADRIANA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0376814---Date of Invoice: 12/1212022 II I I I I I V II iII I V I V I VI VII VII V I1 iI 1111111111111111111 <br /> 12/12/2022 1608 CLASS A COTTAGE FOOD-DIRECT SALES PRO547447 $ 186.00 <br /> Total for[his Invoice $ 186.00 <br /> Payment Due Date 1/30/2023 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period 186.00 <br /> ATTENTION! YOUR CFOT WILL NOT BE RENEWED BY ONLY PAYING THE IN ICE. <br /> NEED TO COMPLETEA D RETURN THE RENEWAL FORM AND INCLUDE A ABEL01" OkE0, U <br /> CFO PRODUCTS. CFO RENEWAL FORM HERE: <br /> littps://www sjgov orv-/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-permittin <br /> 2-renewal-form.pdf/sfvrsn=d950fb44 5 <https://Pcc02.safelinks.protection.outlook.com/? <br /> url=https%3 A%2 F%2Fwww.s a gov.ory%2Fdocs%2 Fdefau It-source%2Fenvironmental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-permitting-renewal-fonn.pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7C01%a7Cjsalwolke%40si <br /> ov org%7COdO58e9dfbee4d8fl Oc3O8dab2233bdc%7C3cff5075176a400d86Oa5496Oa7c7e5l%7CO%7CO%7063801816164 <br /> 0113088%7CUnknown%7CT W FpbGZsb3 d 8eyJ WljoiMC4 wLjAwMDA iLCJOlioi V2luMzl iLCJBTiI61k 1 haW w iLCJX VCI <br /> 6MnO%3 D%7C3000%d7C%7C%7C&sdata=6tRcKMC6hxT5tyggO4bBY 12ImMi7b53zNcmtPtD%2FYTA%3 D&reserved= <br /> 0> <br /> You can return by mail to our department at the address on the top of your invoice or email completed forms and <br /> PCl1 41 � �- 0� <br /> C0kl( I �� 17x388 <br /> Please make Checks PAYABLE to: 'E'r (� <br /> or <br /> Pay online at: 'htti3s://www.siaov.oro/departmentienvhealthifees/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 -pp "14—,-1 Find of report �+ <br /> F 1 1 J <br />