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Official Payments Pay Taxes,Utility Bills,Tuition&More 4 Inline 8/19/15,4:23 PM <br /> This is a "printer friendly"page. Please use the"print"option in your browser to print this screen. <br /> PAYMENTS <br /> San Joaquin County - Environmental Health Department, CA <br /> Environmental Health Fees <br /> Confirmation Number: 062319 <br /> Payment Date: Wednesday,August 19,2015 <br /> Payment Time: 04:23PM PT <br /> Payer Information <br /> Name: Kristal Elaine Betancourt <br /> Street Address: 221 W Arcadia St. <br /> Mountain House,CA 95391 <br /> United States <br /> Daytime Phone (510)303-3648 <br /> Number: <br /> E-mail Address: kristalbetancourt@gmail.com <br /> Please provide as much information as possible below so that we may identify your payment: <br /> Address of Facility <br /> where work is being 911 N Central Blvd,Tracy, Ca 95376 <br /> done: <br /> Buisness Name: 12 Monkeys Tattoo <br /> Invoice Number: IN0266996 <br /> Account Number: AR0041174 <br /> Additional Information: Body Art Practitioner Registration <br /> Card Information <br /> Card Type: Visa <br /> Card Number: ************6359 <br /> Expiration Date: 01/2017 <br /> Payment Information <br /> Payment Type: Environmental Health Fees <br /> Payment Amount: $130.00 <br /> Convenience Fee: $10.95 <br /> Total Payment: $140.95 <br /> Thank you for using Official Payments. If you have a question regarding your payment, please call us toll free at <br /> 1-800-487-4567. To make payments in the future, please visit our website at www.officialpayments.com. <br /> Copyright©2015 Official Payments Corporation.All Rights Reserved. <br /> Official Payments Corporation is a licensed money transmitter in 44 states,the District of Columbia, and Puerto Rico. <br /> Official Payments is not required to be licensed as a money transmitter in Indiana,Massachusetts, Montana, New Mexico, <br /> South Carolina or Wisconsin. <br /> https://www.officialpayments.com/pc_step6_print.jsp;jsessionid=pgQVmhTWuOzMpceS3arhlwSx.worker05 Page 1 of 1 <br />