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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH D&i. tTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> This invoice requested by and produced QUARTERLY Account ID AR0027044 <br /> for. Placer Title Companyba Iniguez STATEMENT OF EXPENSE <br /> 2800 W. March Lane,,#100#100 Program ID F PR0 337938 <br /> Stockton CA 95219 INVOICE <br /> Esc: P-184008 <br /> Facility ID FA-0 115640 <br /> Billing Period : 711/2016-9/3012016 <br /> Date PrintedF 10/5/2016 <br /> RODRIGUEZ,MAYRA <br /> PO BOX 6734 RE: RODRIGUEZ, MAYRA <br /> STOCKTON CA 95206 2156 S B ST <br /> STOCKTON,CA 95206 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0283316---Date of Invoice: 10/5/2016 IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII VIIIVIIIIIIII IIII11111111111111 <br /> 7/21/2016 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $39.00 <br /> Total for this Invoice $39.00 <br /> Only this amount is subject to <br /> ap eal' 11/4/2016 <br /> Please make Checks PAYABLE to: EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> *Right to Appeal : You have the right to appeal this Quarterly Statement of Expense by filing a written <br /> appeal, 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 davs 31 to 60 days 61 to 90 des 91 to 120 days >120 davs Account Balance <br /> $39.00 $39.00 $0.00 $0.00 $0.00 $78.00 , .. <br /> 5250.rpt <br />