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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT Page 1 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Phone: (209) 468-3420 Account ID f AR0027044 This invoice requested by and produced for:Placer Title Company/Rosalba Iniguez INVOICE 2800 W. March Lane,#100 Facility IDf FA0015640 1 Stockton CA 95219 Esc: P-184008 Date Printed 12/12/2016 RODRIGUEZ, MAYRA RE : RODRIGUEZ, MAYRA PO BOX 6734 2156 S B ST STOCKTON, CA 95206 STOCKTON, CA 95206 OWNER : RODRIGUEZ, MAYRA Date Health Program Description Amount Invoice# IN0281798---Date of Invoice: 7/25/2016 Illlllllllllll III I�IIIIIIIIIIIIIIIIIIIII VIII IIIIIIIIIIIIII IIIIIIVI I'll Illi Hrs Employee 5/26/2016 1322 C54-Office-Case Review,Permit Check 0.30 SANGALANG $ 39.00 Total for this Invoice $ 39.00 PAST DUE Invoice# IN0283316---Date of Invoice: 10/5/2016 I lllllll 111111 Ill(IIII(IIII(IIII VIII VIII(IIII VIII(IIII IIII 111111 VIII Illi IIII Hrs Employee 7/21/2016 1322 H54-SUBSTANDARD HOUSING-CASE ACTIVITY Off 0.30 SANGALANG $ 39.00 Total for tlils Invoice $ 39.00 Payment Due Date 11/4/2016 Invoice# IN0285559...Date of Invoice: 12112/2016 I lllllll 111111 Ill VIII(IIII(IIII VIII VIII VIII 11111111111111111111111111111 IIII 12/12/2016 1374 Recording Fee-Release Notice of Violation $ 20.00 Total for this Invoice $ 20.00 Payment Due Date 1/11/2017 TOTAL DUE this Billing Period $ 98.00 NOTE: Afteraffviolatiorts have 6een correctedandaff outstanding er forcernent costs 6a•ve been pair,, a release of "Notice of g,�iolatiott ,iviff6e submitted to t(e San Joaquin County 1pcorder's Office, if applicable. Please make Checks PAYABLE to: 'EHD' — Return a Copy of This STATEMENT with Your PAYMENT Penalties will be added to all Permit Fees For HMBP Fees For all SERVICE FEES 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% 30 Days after the Due Date 45 Days after the Invoice Date 60 Days after the Invoice Date and each 30 Days thereafter szs4.rpt 4 ILIS1