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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPA, . MENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY Account ID I AR0027355 1 <br /> STATEMENT OF EXPENSE Program ID PR0523358�'I <br /> INVOICE Facility ID FA0615782 <br /> Billing Period : 10/1/2015-12/31/2015 _. <br /> Date Printed 1/13/2016 <br /> l <br /> MENDEZ,JOSE L <br /> 2962 S B ST RE: MENDEZ,JOSE L <br /> STOCKTON CA 95206 2962 S B ST <br /> STOCKTON,CA 95206 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0273091 ---Date of Invoice: 1/12/2016 I IIIIIII IIIIII III VIII VIII VIII VIII VIII VIII VIII VIII IIII IIIIII VIII IIII IIII <br /> 11/9/2015 SC54 Office-Case Review,Permit Check $39 0 <br /> Total for this Invoice $39.00 <br /> Only this amount is subject to appeal' _ <br /> Payment Due Date 1/12/2016 <br /> Please make Checks PAYABLE to: EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> MSN �� <br /> hq*60 <br /> 10 <br /> EO <br /> FES co�N-� <br /> `'P`N�N�Av p�P <br /> NEP\1� <br /> *Right to Appeal : You have the right to appeal this Quarterly Statement of Expense by filing a written appeal, <br /> along with the$78.00 filing fee, within 30 calendar days of the date the Statement was mailed. <br /> Pursuant to San Joaquin County Ordinance Code, Section 8-5401(e), all unpaid costs are processed and <br /> placed on the property taxes as a Special Tax Assessment. <br /> Note: A Release of Notice of Violation or Release of Lien will be recorded with the San Joaquin County <br /> Recorder's Office after all violations are corrected and all costs are paid in full. <br /> 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days >120 days Account Balance <br /> $39.00 $0.00 $0.00 $0.00 $0.00 $ 39.00 <br /> 5250.rpt <br />