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Account ID AR0049882 <br />Facility ID FA0026283 <br />Date Printed 9/29/2022 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br />II <br />n.te <br />Amount <br />Health <br />I-'rogram Desc,Tiptic,n <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Page 1 <br />SMITH, DARYL T <br />SMITHS TREATS <br />PO BOX 811 <br />VICTOR, CA 95253 <br />RE: SMITHS TREATS <br />16701 FOX RD <br />LODI, CA 95240 <br />OWNER: SMITH, DARYL T <br />Invoice # IN0374211 --- Date of Invoice : 9/29/2022 <br />1 11 1011 10111 111 1 1111 11111 11 10 11111 11111 III 11 0111 11111 11111 III 1 11111 1 1111 1 1111111 <br />9/29/2022 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PRO546376 $31200 <br /> <br />Total for this Invoice $312.00 <br /> <br />10/3042022 <br />TOTAL DUE this Billing Period!! $ 312.00 <br /> <br />Important! Cottage Permits require application with every renewal annually. Please download and fill out the <br />form at this link to be turned into EHD in order to receive your permit. <br />https://www.sigov.org/department/envhealth/forms <br />PAYMENT <br />RECEIVED <br />DEC 0 2 2022 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL <br />HEALTH DEPARTMENT <br />Would you like Invoices electronically or need to update the email address for this account? Fill out the <br />form below with the information with up to 2 email addresses: <br />Email 1 <br />Email 2 <br />Please make Checks PAYABLE to: 'EHD' or <br />Pay online at: 'hftps://www.sigov.orq/departmentienvhealth/fees/online-fee-pavment' <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 be added at the Rate of 10% <br /> Penalties will be added at the Rate of 10% <br />30 Days after the Due Date 69 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter <br />5254.rpt