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SAN JOAOUIN COUNTY Page 1 <br /> ENVIRONMENTAL HEALTH DEPt MENT <br /> 1868 E HAZELTON AVENUE <br /> STOCKTON. CA 95205 <br /> Phone: (209)468-3420 <br /> QUARTERLY Account ID AR0045710 <br /> STATEMENT OF EXPENSE Program ID PR0542560 <br /> INVOICE <br /> Facility ID FA0024473 <br /> Billing Period : 1/1/2018-3/31/2018 <br /> Date Printed 4/5/2018 <br /> SINGH,AVTAR&KULJIT <br /> 1543 PALAZZO LN RE: SINGH,AVTAR&KULJIT <br /> MANTECA CA 95337 15833 S AIRPORT WAY <br /> MANTECA,CA 95337 <br /> Health <br /> Date Program Description Hrs Employee Amount <br /> Invoice# IN0306356---Date of Invoice: 4/5/2018 I IIIIIII IIIIII III VIII VIII IIIII IIIII IIIII IIIII IIIII IIIII VIII IIII IIIIII VIII IIII IIII <br /> 2/20/2018 SP44 SUBSTANDARD HOUSING-POSTING ACTIVITY $76.00 <br /> 2/20/2018 SH44 SUBSTANDARD HOUSING-INITIAL CASE PREP $76.00 <br /> 2/21/2018 SH54 SUBSTANDARD HOUSING-CASE ACTIVITY Office $152.00 <br /> Total for this Invoice $304.00 <br /> Only this amount is subject to appeal' <br /> Payment Due Date 5/5/2018 <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 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 >120 days Account Balance <br /> $304.00 $0.00 $0.00 $0.00 $0.00 $ 304.00 <br /> 5250.rpt <br />