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SAN JOAOUIN COUNTY j Page 1 <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY Account ID AR0042950 <br /> STATEMENT OF EXPENSE Program ID PR0540807 <br /> INVOICE <br /> Billing Period : 1/1/2016-3/3112016 Facility ID FA0023329 <br /> Date Printed 4/20/2016 <br /> TUCKER,JIMMY A SR <br /> 4321 E GUERNSEY AVE RE: TUCKER,JIMMY A SR <br /> STOCKTON CA 95215 5533 E ARDELLE AVE <br /> STOCKTON,CA 95215 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0278583---Date of Invoice: 4/20/2016 I IIIIII IIIIII III VIII VIII IIIII IIIII IIIII IIIII VIII VIII IIIII IIII IIIIII VIII 1111 1111 <br /> 2/26/2016 SH44 SUBSTANDARD HOUSING-INITIAL CASE PREP $130.00 <br /> 2/26/2016 SP44 SUBSTANDARD HOUSING-POSTING ACTIVITY $65.00 <br /> Total for this Invoice $195.00 <br /> Only this amount is subject to appeal` <br /> Payment Due Date 5/20/2016 <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 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 a'hd <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 dans 7T 61 to 90 days 91 to 120 days >120 days Account Balance <br /> $ 195.00 $0.00 $0.00 $0.00 $0.00 $ 195.00 <br /> 5250.rpt <br />