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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEP,_ _iMENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON. CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY AccountlD AR0043510 <br /> STATEMENT OF EXPENSE Program ID PR0541157 <br /> INVOICE <br /> Billing Period : 7/1/2016-9/30/2016 Facility ID FA0023567 <br /> Date Printed 10/5/2016 <br /> ROGAN,ANGELA TR ETAL <br /> PO BOX 1521 RE: ROGAN,ANGELA TR ETAL <br /> LODI CA 95241 3650 E ACAMPO RD <br /> ACAMPO,CA 95220 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0283331 ---Date of Invoice: 10/5/2016 11111 1111 111111 11111 IN IN <br /> 7/22/2016 SMH4 MOBILE HOME POSTING-UNSAFE TO OCCUPY $39.00 <br /> 7/22/2016 SH44 SUBSTANDARD HOUSING-INITIAL CASE PREP $117.00 <br /> 7/25/2016 SH44 SUBSTANDARD HOUSING-INITIAL CASE PREP <br /> P St�\ ` � Total for this Invoice $221.00 <br /> 11 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 /> PAYMENT <br /> REC5IVED <br /> NOV 0-3 20% <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL <br /> HEALTH DEPARTMENT <br /> C1`ovA <br /> Y <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 davs 91 to 120 days >120 days Account Balance <br /> $221.00 $0.00 $0.00 $ 0.00 $0.00 $221.00 <br /> 5250.rpt <br />