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San Joaquin County Environmental Health <br /> SAN :10 A Q U I N 1868 E. Hazelton Ave. <br /> f� Stockton CA 95205 <br /> C O U N 1- Y-- (209)468-3420 <br /> AS <br /> °� P'� Greatness grows here. <br /> 4�l�tyR'�r� <br /> Receipt <br /> Payment Information <br /> Payment Date <br /> 0510312023 01:00 PM PST <br /> Payment Status <br /> AUTHORIZED <br /> Confirmation Number <br /> 161577235 <br /> Payment Method <br /> Credit Card (VISA) '******'***'5541 <br /> Expiration <br /> Transaction Type <br /> Purchase <br /> Bill To <br /> John Masellis <br /> 119 Albers Rd . Modesto, CA, 95357, US <br /> Payment Towards <br /> Payment Towards Service Request Or Well Amount $651.00 <br /> Permit <br /> Site Address 20588 Santa Fe Rd Business Name Masellis Drilling, Inc <br /> Phone Number 2095221928 <br /> Charge Information <br /> Agency Amount +'+�et®�Y 1 � <br /> I'y 1 S651.00 <br /> LexisNexis Service Fee <br /> $14.91 <br /> Total Amount <br /> 5665.91 <br />