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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPAL _RENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON, CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY Account ID AR0045408 <br /> STATEMENT OF EXPENSE Program ID PR0542409 <br /> INVOICE <br /> Facility ID FA0024368 <br /> Billing Period : 10/1/2017-12/31/2017 <br /> Date Printed 1/30 <br /> BOUN,BODAVY K <br /> 3067 MARSTON WAY RE: BOUN, BODAVY K <br /> SAN JOSE CA 95148 19541956 N AUTO AVE <br /> STOCKTON, CA 95205 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0304895---Date of Invoice: 1/30/2018 11111111 111111 III VIII VIII VIII VIII VIII VIII VIII VIII VIII 1111111111 VIII IIII IIII <br /> 11/30/2017 SB44 SUBSTANDARD HOUSING-404B POSTING ACTIVITY $258.40 <br /> 12/1/2017 SH44 SUBSTANDARD HOUSING-INITIAL CASE PREP $258.40 <br /> 12/4/2017 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $76.00 <br /> Total for thisInvoice $ 2.80 <br /> Only this amount is subject to appeal <br /> Payment Due Date 3/1/2018 <br /> Please make Checks PAYABLE to : EHD / Return a Copy of This STATEMENT with Your PAYMENT <br /> PA tye, <br /> ieb <br /> AMR g � ?0'8 �\L_ <br /> Sq'JO <br /> AII"F, rRR�PARTM LNiY <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 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 days 61 to 90 days 91 to 120 days 1120 days Account Balance <br /> $592.80 $0.00 $ 0.00 $ 0.00 $0.00 $592.8 0 592.80 <br /> 5250.rpt <br />