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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEP. 'MENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON. CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY AccountlD AR0043557 <br /> STATEMENT OF EXPENSE <br /> Program ID PR0541190 <br /> INVOICE <br /> Billing Period : 7/1/2016-9/30/2016 Facility ID FA0023590 <br /> Date Printed 10/5/2016 <br /> US BANK TR <br /> 3217 S DECKER LAKE DR RE: US BANK TR <br /> SALT LAKE CITY UT 84119 712 S ANTEROS AVE <br /> STOCKTON,CA 95215 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0283355---Date of Invoice: 10/5/2016 11111 11111 1111 111111 11111 1111 IN <br /> 8/9/2016 SB44 SUBSTANDARD HOUSING-404B POSTING ACTIVITY $69.50 <br /> 8/9/2016 SBP4 BOARD&SECURE NOTICE-POSTING ACTIVITY $41.70 <br /> 8/9/2016 SP44 SUBSTANDARD HOUSING-POSTING ACTIVITY $27.80 <br /> 8/9/2016 SH44 SUBSTANDARD HOUSING-INITIAL CASE PREP $180.70 <br /> 8/16/2016 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $69.50 <br /> Total for this Invoice $389.20 <br /> Only this amount is subject to <br /> Payment 4 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 days 31 to 60 da s• 61 to 90 days 91 to 120 daVs- <br /> >120 days Account Balance <br /> $ 389.20 $0.00 $0.00 $ 0.00 $0.00 $389.20 <br /> 5250,rpt <br />