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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 AR0053054 <br /> INVOICE <br /> Return This INVOICE with Your PAYMENT Facility ID FA0027486 <br /> Date Printed 1/4/2023 <br /> LICENSING RE : SPROUTS FARMERS MARKET <br /> SPROUTS FARMERS MARKET 16576 GOLDEN VALLEY PKWY <br /> 5455 E HIGH ST STE 111 LATHROP, CA 95330 <br /> PHOENIX, AZ 85054 <br /> OWNER : SF MARKETS LLC <br /> Date Health <br /> Program Description Amount <br /> Invoice# IN0377341 ---Date of Invoice: 1/4/2023 IIIIIII IIIIII III IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIIIII IIIII IIII IIII <br /> 1/4/2023 1619 RETAIL MKT>1000 SQ FT(=/>2 DEPTS) PR0548169 S 500.00 <br /> Total for this Invoice $ 500.00 <br /> 3/2/2023 <br /> TOTAL DUE this Billing Period $ 500.00 <br /> Please make Checks PAYABLE to: 'EHD' <br /> or <br /> Pay online at: 'https://www siaov.orct/department/envhealth/fees/online-fee-i)avment' <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 /> 5254.rpt I:nd of rchurl <br />