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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEP, MENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON. CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY Account ID AR0027355 <br /> STATEMENT OF EXPENSE Case# 012710 <br /> Billing Period : 10/1/2014-12/31/2014 <br /> Facility ID I FA0015782 111 <br /> Date Printed 2/6/2015 <br /> MENDEZ,JOSE L <br /> 2962 S B ST <br /> STOCKTON CA 95206 RE: MENDEZ,JOSE L <br /> 2962 S B ST <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0263541 ---Date of Invoice: 2/5/2015 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIVIIIININ <br /> 10/2/2014 SC54 Office-Case Review, Permit Check $26.00 <br /> 10/2/2014 SP54 Office-Phone, Counter Consultation 00 <br /> Total for this Invoice $52.00 <br /> Only this amount is subject to appeal <br /> Please make Checks PAYABLE to : EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> P9062-3 ;' SX Pk 4f�).o� <br /> P eC ,"VeD <br /> R 6. 10 <br /> N�OAC000v <br /> QUMPAL NT <br /> SA EN�tPO <br /> DE ppFtTM1E <br /> HEpt'�H <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 /> __j <br /> $ 52.00 $ 0.00 $ 0.00 $0.00 $ 0.00 $52.00 <br /> 5250.rpt <br />