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N <br />Official Payments -PayTax tility Bills, Tuition &More Online <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: <br />Payment Date: <br />Payment Time: <br />Payer Information <br />Name: <br />Street Address: <br />09957S <br />Monday, December 23, 2013 <br />11:03AM PT <br />Marisela Mejia <br />1145 W. Charter Way <br />Stockton, CA 95206 <br />United States <br />Daytime Phone (209) 547 - 7514 <br />Number: <br />Email Address: mmejia@republicservices.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 9999 S. Austin Road, Manteca, CA 95336 <br />done: <br />Buisness Name: Forward RRF 39 -AA -0020 <br />Card Information <br />Card Type: Visa <br />Card Number: -*--**-7388 <br />Expiration Date: 11x2015 <br />Payment Information <br />Page 1 of 1 <br />Payment Type: Environmental Health Fees <br />Payment Amount: $625.00 <br />Convenience Fee: $10.95 <br />Total Payment: $635.95 <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, <br />��please <br />��IIlIvisit our website at www,officialpayments.com. <br />�Q <br />Copyright © 2013 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.comlpc_step6_print. j sp?JSESSIONID=cxtLS4GMbQhBf5... 12/23/2013 <br />