Laserfiche WebLink
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 AR0052927 <br /> INVOICE <br /> Re <br /> <br /> ED GLUTENLESS BAKERY <br /> BLESSED GLUTENLESS BAKERY 14811 MANZANITA WAY <br /> 14811 MANZANITA WAY LOCKEFORD, CA 95237 <br /> LOCKEFORD, CA 95237 <br /> OWNER : FUTCH, MICHELLE S <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0376712---Date of Invoice: 1215/2022 IIIIIIIVII VVII VIII VIIVII VIIIVIIVIIIIII IIIIII IIIIIIIII IIII <br /> 12/5/2022 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PRO548117 $ 312.00 <br /> Total for this Invoice $ 312.00 <br /> 1130/2023 <br /> TOTAL DUE this Billing Period $ 312.00 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOICE. YOU <br /> NEED TO COMPLETE AND RETURN THE RENEWAL FORM AND INCLUDE A LABEL OF ONE OF YOUR <br /> CEO PRODUCTS. CFO RENEWAL FORM HERE: <br /> https://www.sj og v orp/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-relzistration-perrnittin <br /> g-renewal-form.pdVsfvrsn=d950fb44 5 <Iittps:HgccO2.safelinks.protection.outlook.com/? <br /> url=https%3 A%2F%2Fwww.sjgov.ora%2Fdocs%2Fdefau It-source%2Fenvironmental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-re2istration-pennitting-renewal-form.pdf%3Fsfvrsn%3Dd950tb44 5&data=05%7001%7Cisalwolke%40sjg <br /> ov.orz%7C0d058e9dfbee4d8f10c308dab2233bdc%7C3cff5075176a400d860a54960a7c7e5l%7C0%7C0%7063801816164 <br /> 01 1 3088%7CUnknown%7CTWFpbGZsb3d8eyJ WIjoiMC4wL*AwMDAiLCJOI ioi V2luMzl iLCJBTil6Ik 1 haWwiLCJXVC I <br /> 6Mn0%3 D%7C3000%7C%7C%7C&sdata=6tReKMC6hxT5tyggO4bBY 121 mM'7b53zNcmtPtD%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 /> PAYMENT <br /> RECEIVED <br /> ptC 0 5 2071 <br /> ,AN JOAQUIN COUNTY, <br /> E_'R=E'%MAFLE <br /> nt ALT"DEPARraH✓ <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at; 'httos://www.siaov.orddeoartment/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 Date60 Days after the Invoice Date and each 30 Days thereafter <br /> 1717 <br /> 5254.rpt 05LIg( I /��ft laid of report <br />