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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 />Page 1 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br />Account ID <br />Facility ID <br />Date Printed <br />AR00539-1 <br />FA0027609 111 <br />5/14/2024 I <br />PINEDA, ALMA RE: CARTER SIX <br />CARTER SIX <br />99 W BRILLOSO LN <br />99 W BRILLOSO LN MOUNTAIN HOUSE, CA 95391 <br />MOUNTAIN HOUSE, CA 95391 <br />OWNER: PINEDA, ALMA A <br />Date Health <br />Program Description Amount <br />Invoice # IN0391980 --- Date of Invoice : 3/15/2024 <br /> <br />1111111111111111111111 HIME <br />3/15/2024 1608 CLASS A COTTAGE FOOD-DIRECT SALES <br /> <br />PR0548352 $ 186.00 <br />Total for this Invoice <br />Payment Due Date 4/30/2024 <br />TOTAL DUE this Billing Periol $ 186.00 <br /> <br />ATTENTION! YOUR CFO PERMIT WILI4 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 />CFO PRODUCTS. CFO RENEWAL FORM HERE: <br />https://www.sjgov.org/department/envhealth/forms <br />You can return by mail to our department at the address on the top of your invoice or email completed forms and <br />confirmation of payment to: jcastaneda@sjgov.org <mailto:jcastaneda@sjgov.org, <br />Please make Checks PAYABLE to: 'EHD' <br />or <br />Pay online at: 'httos://www.sjgov.org/department/envhealth/feesionlinetee-Dayment' <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% <br /> <br />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 />186.00 <br />1254.rpt I nd ol report