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Paid in Full <br />$468.00 <br />$0.00 <br />$10.72 <br />$478.72 <br />Bill To <br />Pedro Baires <br />3760 39th Ave Apt B <br />Oakland, CA 94619 <br />United States of America <br />Authorization: <br />Agency Amount: <br />Other Agency Amount: <br />LN Service Fee: <br />Total Amount(USD): <br />Refund Policy: Please contact the agency listed on the receipt to request a <br />refund. <br />10 San Joaquin County Environmental Health <br />1868 E. Hazelton Ave. <br />Stockton, CA 95205 <br />209-468-3420 <br />Source: <br />Order Date/Time: <br />Order Number: <br />Operator: <br />Location Code: <br />Web Order (Card Keyed-In) <br />9/16/2022 10:08 AM PDT <br />150010399 <br />**********006 <br />Authorization: Paid in Full <br />Agency Amount: $468.00 <br />Other Agency Amount: $0.00 <br />Shipping Amount: $0.00 <br />LN Service Fee: $10.72 <br />Total Amount(USD): $478.72 <br />Payment Information <br />Transaction Type: <br />Card Holder: <br />Payment Method: <br />Approval Code: <br />AVS Response: <br />Purchase <br />Pedro Baires <br />Credit Card (VISA ************9209) <br />04884C <br />Y <br />Expiration <br />Transaction Ref #: <br />CVV2 Response: <br />Val Code: <br />##/## <br />83900001 <br />M <br />Merchant Copy <br />Agency Amount <br />$468.00 <br />Product <br />Service Request Or Well Permit <br />Product Detail <br />4950 Pacific Ave, Suite 445, Stockton CA <br />95207 <br />FiveBelow <br />7204960888 <br />San Joaquin County Environmental Health <br />1868 E. Hazelton Ave., Stockton, CA 95205 <br />209-468-3420 <br />VitalChek Receipt - Web Order (Card Keyed-In) <br />Cardholder Copy <br />Order Date/Time: 9/16/2022 10:08 AM PDT <br /> Transaction Type: Purchase <br />Confirmation Number: 150010399 <br /> Approval Code: 04884C <br />Payment Applied towards: Service Request Or Well Permit <br /> Transaction Ref #: 83900001 <br />Card Holder: Pedro Baires Payment Method: VI(9209)