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SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1868 E HAZELTON AVENUE <br />STOCKTON, CA 95205 <br />Phone: (209) 468-3420 <br />Amount ID <br />INVOICE <br />Return This INVOICE with Your PAYMENT Faciiity ID <br />Date Printed <br />EDSELL, JULIE RE: ELLIOTT ROAD BARN <br />ELLIOTT ROAD BARN 23216 N ELLIOTT RD <br />23216 N ELLIOTT RD ACAMPO, CA 95220 <br />ACAMPO, CA 95220 <br />OWNER: EDSELL, JULIE M <br />Page 1 <br />AR0050452 <br />FA0026501 <br />F—T312-7-0-2-3--i <br />INNOWEEMMMMEnd <br />Date Health <br />Program Description Amount <br />Invoice # IN0377820 --- Date of Invoice: 2/16/2023 <br />2/16/2023 1608 CLASS A COTTAGE FOOD -DIRECT SALES <br />SECOND NOTICE <br />PR0546753 $ 186.00 <br />Total for this Invoice $ 186.00 <br />Payment Due Date 3130/2023 <br />TOTAL DUE this Billing Period 186.00 <br />CFO PRODUCTS. CFO RENEWAL FORM HERE: <br />https://www sieov.orp/does/default-source/environmental-health-dOCL[ments/food-and-restaurants/cfo-reizistration-permittin <br />e=renewal-form.pdf?sfvrsn=d950tb44 5 <https:Hacc02.safelinks.protection.outlook.com/? <br />url=https%3 A%2F%2Fwww.sjgov.ore%2Fdocs%2Fdefault-source%2Fenvironmental-health-documents%2Ffood-and-resta <br />urants%2Fcfo-registration-permitting-renewal-form pdf%3Fsfvrsn%3Dd950tb44 5&data=05%7C0I%7Cjsalwolke%40sjg <br />ov.org%7COd058e9dfbee4d8fl Oc308dab2233bdc%7C3cff5075176a400d860a54960a7c7e5l%7C0%7CO%7C63801816164 <br />O I 13088%7CUnknown%7CTW FpbGZsb3 d8e% J WljoiMC4wLjAwMDAiLCJOIjoiV2luMzliLCJBTil6lk 1 haWwiLCJXVCI <br />6Mn0%3 D%7C3000%7C%7C%7C&sdata=6tRc KMC6hxT5tv2aO4bBY 12lmMi7b53zNcmtPt_D%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 />Pf\, d 1 3/z 3/,� 3 <br />y � <br />Please make Checks PAYABLE to: 'EHD' <br />or <br />Pay online at: 'https://www.sigov.org/departmenttenvhealthlfees/online-fee-Daymenf <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.rpl w5, kpT '3 End of report <br />