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SAN J04QUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> Account ID AR0047796 <br /> INVO <br /> <br /> 021 <br /> GUPTA, MAMTA RE : MASALA BLEND <br /> MASALA BLEND 2127 SADDLEBROOK ST <br /> 2127 SADDLEBROOK ST STOCKTON, CA 95209 <br /> STOCKTON, CA 95209 <br /> OWNER : GUPTA, MAMTA <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0352969---Date of Invoice: 5/26/2021 1111111111111111111111111111111111IN <br /> 5/26/2021 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PRO544635 5 310.00 <br /> Total for this Invoice S 310.00 <br /> 30/2021 <br /> TOTAL DUE this Billing Periodl $ 310.00 <br /> Cottage Permits require application with every renewal annually. Please download and fill out the form at this link to be turn into E <br /> cfo reg-permitting renewal form.pdf(sigov.org) <br /> S <br /> REc ti 12p2� <br /> JJ 6PEN�N�N�j�EN� <br /> tlyj'��OE <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https:(/www.sjgov ordepartmentlenvhealth/online-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 /> 52`TT pt I'md of i cpurt <br /> I��.o�tN(o35 <br />