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SAN JOAOUIN COUNTY Page 1 ENVIRONMENTAL HEALTH DEI TMENT 1868 E HAZELTON AVENUE STOCKTON, CA 95205 Phone: (209)468-3420 QUARTERLY Account ID AR0043557 STATEMENT OF EXPENSE Program ID PR0541190 INVOICE Facility ID FA0023590 Billing Period : 10/1/2016-12/31/2016 Date Printed 1/11/2017 US BANK TR 3217 S DECKER LAKE DR RE: US BANK TR SALT LAKE CITY UT 84119 712 S ANTEROS AVE STOCKTON,CA 95215 Health Date Program Description Hrs Employee Amount Invoice# IN0286119---Date of Invoice: 1/11/2017 IIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIII IIIIIIIIIIIIIIIIIIIIIIIIIIIIII IN111I 10/12/2016 SF54 SUBSTANDARD HOUSING-FIELD ACTIVITY $83.40 10/12/2016 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $83.40 10/13/2016 1371 Title Search Expense $150.00 11/3/2016 SBHN Posting-BONA Hearing Notice $97.30 11/7/2016 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $208.50 11/8/2016 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $166.80 11/16/2016 S979 BOARD/COMMISSION MTG-CASE HEARING $41.70 12/7/2016 SBHR Posting-BONA Hearing Resolution $83.40 Total for this Invoice $914.50 Only this amount is subject to appeal Payment Due Date 2/10/2017 Please make Checks PAYABLE to : EHD / Return a Copy of This STATEMENT with Your PAYMENT *Right to Appeal : You have the right to appeal this Quarterly Statement of Expense by filing a written appeal, along with the $78.00 filing fee,within 30 calendar days of the date the Statement was mailed. Pursuant to San Joaquin County Ordinance Code, Section 8-5401(e), all unpaid costs are processed and placed on the property taxes as a Special Tax Assessment. Note: A Release of Notice of Violation or Release of Lien will be recorded with the San Joaquin County Recorder's Office after all violations are corrected and all costs are paid in full. 0 to 30 days 31 to 60 days 61 to 90 days 91 to 120 days >120 days Account Balah„e $914.50 $0.00 • $ 389.20 $0.00 $0.00 $ 1,303.70 5250.rpt