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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br /> <br /> <br /> <br /> <br />Page 1 <br />Account ID AR0042710 <br />Facility ID F FA0023227 <br />LMOMMMMMMOMM <br />Date Printed 2/15/2022 <br />RE: AINSLIE LANE COOKIE STUDIO <br />223 ARCADIA PL <br />LODI, CA 95240 <br />OWNER: WOOD, KATHRYN <br />Date Health <br />Program Description Amount <br />Invoice # IN0355623 --- Date of Invoice: 9123/2021 <br />9/23/2021 1608 CLASS A COTTAGE FOOD -DIRECT SALES <br />ATTENTION <br />YOUR HEALTH PERMIT <br />FOR THE CURRENT YEAR <br />MAY NOT BE ISSUED UNTIL <br />PAST DUE AMOUNTS ARE <br />PAID IN FULL <br />PAST DUE! <br />Delinquent charges over <br />90 days! <br />I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br />PR0540609 $ 155.00 <br />Total for this Invoice I $ 155.00 <br />Payment Due Date 10/30/2u21 <br />TOTAL DUE this Billing Period $ <br />`&I.111I11 <br />Important! Cottage Permits require application with every renewal annually. Please download and fill aut-the <br />form at this link to be turned into EHD in order to receive your permit. <br />httos://www.s iaov. o r¢/department/envh ea lth/form s <br />��t d <br />5E I/ z <br />Cole' -1 1397a (911 z <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:'hftps://www.siciov.orcVdepartmentlenvheaftlVfees/online-fee-t)avment' <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 End of report <br />