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.An Joaquin County Environmental Health <br /> 1868 E.Hazelton Ave. <br /> Stockton,CA 95205 <br /> 209-468-3420 <br /> Source: Web Order(Card Keyed-In) Authorization: Paid in Full <br /> Order Date/Time: 12/1/2019 11:37 AM PST Agency Amount: $456.00 <br /> Order Number: 101934412 Other Agency Amount: $0.00 <br /> Operator: Shipping Amount: $0.00 <br /> Location Code: **********006 LN Service Fee: $10.44 <br /> Total Amount(USD): $466.44 <br /> Payment Information <br /> Transaction Type: Purchase Expiration <br /> Card Holder: Robert Moniz Transaction Ref#: 202400001 <br /> Payment Method: Credit Card(VISA************6199) CVV2 Response: <br /> Approval Code: 02525C Auth Txn Id#: <br /> AVS Response: Y Val Code: <br /> Merchant Copy <br /> Agency Amount Product Product Detail <br /> $456.00 Service Request Or Well Permit Alden Park Site <br /> Chevon EMC <br /> 9257887377 <br /> ------------------------------------------------------------------------------------------------------------------------------------------------------------------- <br /> San Joaquin County Environmental Health <br /> 1868 E.Hazelton Ave.,Stockton,CA 95205 <br /> 209-468-3420 <br /> VitalChek Receipt-Web Order(Card Keyed-In) <br /> Cardholder Copy <br /> Order Date/Time: 12/1/2019 11:37 AM PST Transaction Type: Purchase <br /> Confirmation Number: 101934412 Approval Code: 02525C <br /> Payment Applied towards: Service Request Or Well Permit Transaction Ref#: 202400001 <br /> Card Holder: Robert Moniz Payment Method: VI(6199) <br /> Bill To <br /> Robert Moniz Authorization: Paid in Full <br /> 310 Sunset Rd Agency Amount: $456.00 <br /> Other Agency Amount: $0.00 <br /> Pleasant Hill, CA 94523 LN Service Fee: $10.44 <br /> United States of America Total Amount(USD): $466.44 <br /> Refund Policy:Please contact the agency listed on the receipt to request a <br /> refund. <br />