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SAN JOAQUIN COUNTY <br /> EN\;RONMF-NTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0047019 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0025027 <br /> Date Printed 1/24/2023 <br /> SELGA, VANESSA RE : VS CUSTOM CONFECTIONS <br /> VS CUSTOM CONFECTIONS 8351 CRUDEN ST <br /> 8351 CRUDEN ST STOCKTON,CA 95209 <br /> STOCKTON,CA 95209 <br /> OWNER : SELGA, VANESSA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0376801 ---Date of Invoice: 12/12/2022 I IIIIIII IIIIII III VIII VIII(IIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 12/12/2022 1608 CLASS A COTTAGE FOOD-DIRECT SALES PR0544014 $ 186.00 <br /> Total for this Invoice $ 186.00 <br /> Payment Due Date 1/30/2023 <br /> SECOND NOTICE <br /> TOTAL DUE this Billing Period $ 186.00 <br /> ATTENTION! YOUR CFO PERMIT WILL 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.s ,ov.ory/docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-permittin <br /> g;-renewal-form.pdflsfvrsn=d950fb44 5 <https:Hgcc02.safelinks.protection.outlook.com/? <br /> url=https%3A%2F%2Fwww.sj o� v_org%2Fdocs%2Fdefault-source%2Fenvirontnental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-pertnitting-renewal-form.pdf%3Fsfvrsn%3Dd950fb44 5&data=05%7COI%7Cjsalwolke%40sjg <br /> ov.org%7C0d058e9dfbee4d8f10c308dab2233bdc%7C3cff5075176a400d860a54960a7c7e5 l%7C0%7CO%7C63801816164 <br /> 0113088%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLiAwMDAiLCJQIjoiV2luMzliLCJBTiI6lk1 haWwiLCJXVCI <br /> 6MnO%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tygg44bBY 121mMi7b53zNcmtPtD%2FYTA%3 D&reserved= <br /> 0> <br /> You can return by mail to our department at the address on the top of your invoice or email completed forms and <br /> PAYMENT <br /> RECEIVED <br /> JAN 2 3 2023 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HFJILTM DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https://www.sigov.orQ/department/envhealth/fees/online-fee-payment' <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 End of report <br />