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SAN .!,iAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Page 1 <br /> <br />Account ID <br />Facility ID <br />Date Printed <br />AR0052127 <br />INVOICE <br />Return This INVOICE with Your PAYMENT <br />FA0027178 <br /> <br />4/8/2024 <br />CASAS, DEZARE <br />THE COO KIELYFE <br />2274 MORNINGSIDE CT <br />TRACY, CA 95376 <br />RE: THE COOKIE LYFE <br />2274 MORNINGSIDE CT <br />TRACY, CA 95376 <br />OWNER: CASAS, DEZARE <br />Date Health <br />Program Description Amount <br />Invoice # IN0392911 — Date of Invoice: 4/8 /2024 <br /> <br />1111111111111111111111111111111111111111111111111111111111111111111111111111111111 <br />4/8/2024 1608 CLASS A COTTAGE FOOD-DIRECT SALES <br /> PRO547719 <br /> 186 00 <br /> <br />Total for this Invoice 186.00 <br /> <br />5/30/2024 <br /> <br />TOTAL DUE this Billing Period <br /> <br />$ 186.00 <br /> <br />ATTENTION! YOUR CFO PERMIT WILL NOT BE RENEWED BY ONLY PAYING THE INVOICE. YOU <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.orvidepartment/envhealth/forms <br />You can return by mail to our department at the address on the top of your invoice or email completed forms and <br />ov Or <mailto..castanedda's. ,ov.or 1-> confirmation of payment to: .castaneda <br />2- <br />0 V-- ( er\ per . <br />? ec.yze eloc-es 5 <br />-Z....CNC <br />Please make Checks PAYABLE to: 'END' <br />Or <br />Pay online at: 'hHos://www.sigov,orgidenartmentienvhealthifeesionline-fee-payment. <br />Penalties will be added to all Permit Fees <br />at the Rate of 100% of the Base Fee <br />30 Days after the Due Date <br />For HMBP Fees <br />Penalties will be added at the Rate of 10% <br />60 Days after the Invoice Date <br />For all SERVICE FEES <br />Penalties will be added at the Rate of 10% <br />60 Days after the Invoice Date and each 30 Days thereafter <br />5254.rpt Fnd of report