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SAN JOAQUIN COUNTY <br /> ENVlkftMEivTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0054560 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT FacilitylD FA0028047 <br /> Date Printed 2/2/2024 <br /> LOPEZ,ANTONIO RE : ST CANDY CO <br /> ST CANDY CO 18437 LODESTONE ST <br /> 2223 COCHRAN RD WOODBRIDGE, CA 95258 <br /> LODI, CA 95242 <br /> OWNER : LOPEZ,ANTONIO <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0391268---Date of Invoice: 2/2/2024 11111 U111 U 11111 1�11 11111 11111 11111 111 1111�11111 11111 1111 111111 11111 1111 IN <br /> 2/2/2024 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PR0548923 $ 486.00 <br /> Total for this Invoice $ 486.00 <br /> 3/50/2024 <br /> TOTAL DUE this Billing Period $ 486.00' <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING <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.si2ov.orgJdel2artment/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: icastaneda&sisov.orp-<mailto:jcastanedanae isov.or;�> <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'htti2s://www.sjciov.orci/dei)artment/envhealtwfees/online-fee-12ayment' <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 Fnd of rcport <br />