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SAN JOAQUIN COUNTY <br />ENVIRON64ENTA!, HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Page 1 <br />Account ID AR0052226 <br />INVOICE <br />Return This INVOICE with Your PAYMENT Facility ID FA0027211 <br />Date Printed 6/8/2022 <br /> <br /> <br /> <br /> <br />OWNER: STOUT, STACIA L <br />Date Health <br />Program Description Amount <br />Invoice# IN0367561 -- Date of Invoice : 6/812022 11111111111111111111111111111111111111111111111111111111111111111111 <br />6/8/2022 1608 CLASS A COTTAGE FOOD -DIRECT SALES PRO547771 $ 155.00 <br />Total for this Invoice I $ 155.00 <br />TOTAL DUE this Billing Period 155.00 <br />Important! Cottage Permits require application with every renewal annually. Please download an III out the <br />form at this link to be turned into EHD in order to receive your permit. <br />htti)s://www.s6gov.org/department/envheath forms <br />n- PAYMENT <br />�S 1� RECEIVED <br />/y' 5 ��/� �a�I'' 1r/• V JUN Q 8 2022 <br />NV PONMENIPLTM <br />11nL1ry OEPPRTMENr <br />w 1 <br />eoWould you like Invoices electronically or need to update the email address for this account? Fill out the <br />form below with the information with up to 2 email addresses: <br />Email 1 <br />Email 2 <br />Please make Checks PAYABLE to: 'EHD' or <br />Pay online at: 'https://www.siaov.orcgder)artmentienvhealtlVfeesionline-fee-payment' <br />Penalties will be added to all Permit Fees <br />For HMBP Fees <br />For all SERVICE FEES <br />at the Rate of 100% of the Base Fee <br />Penalties will be added at the Rate of 10% <br />Penalties will be added at the Rate of 10% <br />30 Days after the Due Date <br />60 Days after the Invoice Date <br />60 Days after the Invoice Date and each 30 Days thereafter <br />5254.rpt Pi 0'5 Lli 11' � I End of report <br />