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G _ _ <br /> 4. 2013'' 3: 37PMY"'a;TE-rgNICON Allis, fullAwI & IV101'cVlllme NO, 13Q5 A4P. 5"= <br /> This is a"printer friendly"page.Please use the"print"option in your browser to print this screen. <br /> I <br /> OFFICIA'L <br /> AAM E T S <br /> San Joaquin County - Environmental Health Department, CA <br /> � Environmental Health Fees <br /> I <br /> Confirmation Dumber: 793479 <br /> Payment Date: Tuesday,June 4,2013 <br /> Payment Time: 11:05AM PT <br /> Payer Information <br /> Name: Ana Miller <br /> Street Address: 4539 N.Brawley Avenue <br /> Suite 108 <br /> Fresno,CA 93722 <br /> United States <br /> Daytime Phone (559)276.9311 <br /> Number: <br /> E-mail Address: ti#fanig@technicon.net <br /> Please provide as much information as possible below so that we mey identify your payment: <br /> Address of Facility <br /> where work is being 560 Tracy Boulevard <br /> done: <br /> Buisness Name, Technicon <br /> Additional Information: Boyd Service Center <br /> Card Information <br /> Card Type' Visa <br /> Card Number: 4217 <br /> expiration Date: 0112014 <br /> Payment Information <br /> Payment Type: Environmental Health s=ees <br /> Payment Amount: $875.00 <br /> Convenience Fee: $10.95 <br /> Total Payment: $885.95 <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,please visit our website at www.omcialpaym@nW.com. <br /> Copyright©2013 Official Payments Corporation.All Rights Reserved. <br /> https://www.offiicialpayments.com/pc_stepb_print i sp?JSESSIONID-12vLRrlTFmvQGO9h!1... 6/4/2013 <br />