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SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT Page 1 <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209) 468-3420 <br /> Account ID AR0048703 <br /> INVOICE <br /> FacilitylD FA0025759 <br /> Return This INVOICE with Your PAYMENT <br /> Date Printed 1/5/2023 <br /> BRUNS, KRISTIN RE : HOMESTEAD <br /> HOMESTEAD 20700 S MURPHY RD <br /> 20700 S MURPHY RD RIPON, CA 95366 <br /> RIPON, CA 95366 <br /> OWNER : BRUNS, KRISTIN <br /> Health <br /> Date <br /> i Program Description Amount <br /> Invoice# IN0377300---Date of Invoice: 12/29/2022 1111 111111 11111 1111 IN <br /> 12/29/2022 1609 CLASS B COTTAGE FOOD-INDIRECT SALES PR0545333 $ 312.00 <br /> Total for this Invoice $ 2. <br /> 11/301202 3 <br /> TOTAL DUE this Billing Period $ 312.00 <br /> ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOICE. Y U <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.sigov.or&docs/default-source/environmental-health-documents/food-and-restaurants/cfo-registration-perm ittin <br /> g-renewal-form.pdf?sfvrsn=d950fb44_5 <https:Hgcc02.safelinks.protection.outlook.com/? <br /> url=https%3A%2F%2Fwww.s jgov.org%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br /> urants%2Fcfo-registration-permitting-renewal-form.pdf%3Fsfyrsn%3Dd95Ofb44 5&data=05%7C01%7Cjsalwolke%40sj� <br /> ov.org%7COdO58e9df bee4d8f10c308dab2233bdc%7C3 cff 5075176a400d86Oa5496Oa7c7e5 l%7C0%7CO%7C63 801816164 <br /> 0113088%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJOIjoiV2luMzliLCJBTiI6lk1 haWwiLCJXVCI <br /> 6MnO%3D%7C3000%7C%7C%7C&sdata=6tRcKMC6hxT5tygg04bBY12ImMj7b53zNcmtPtD%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 /> RFCFIVED <br /> FEB 16 2023 <br /> S,%NO ON 0,31, A LTY <br /> µ,'LTH DEPARTMENT <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https://www.siaov.org/dei3artment/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 /> >_>t rht End of rep <br />