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SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. HAZELTON AVE. , <br /> P O BOX 2009, STOCKTON, CA 95201 <br /> DILL FOR. SERVICES RENDERED <br /> TIME MINIMUM FOR EACH INSPECTION-1 HOUR. ADDITIONAL INSPECTION TIME <br /> WILL BE COMPUTED TO NEAREST 1/2 HOUR INCLUDING TRAVEL TIME. <br /> NOTE: PRIOR TO ALL INSPECTIONS, CONTRACTORS ARE REQUIRED TO GIVE NOTICE <br /> AS SPECIFIED ON THE PERMIT <br /> T �APPLICATION. <br /> ZPPL I CAT I O,,N. r <br /> SITUS ADDRESS:,z,�DGI S(- i =1_ PERMIT # <br /> HILL TO: NAME <br /> ADDRESS <br /> CITY/STATE ZIP <br /> PROGRAM: <br /> DESCRIPTION OF SERVICES) : C L_ <br /> DATE TOTAL WEEk:DAYS WEEK. <br /> NIGHTSWEEk:ENDS/HOLIDAYS SANITARIAN <br /> OF BAM-4 :30PM 4:3()PM-GAM <br /> SERVICE HRS WORKED S35/HR $52. 50/HR $70/HR . <br /> X0'3 3e <br /> TOTALS_ - - - --- _ - - <br /> — - BALANCE <br /> BILLING DATE___-- MEN f IS TO BE RECEIVED WITHIN <br /> DAYS FROM THE BILLING DATE . <br /> RETURN ONE COPY OF THIS BILL ALONG WITH F'AYMENI , MAKE CHECKS PAYABLE <br /> 'TO: SAN JOAQU I N LOCAL HEALTH DISTRICT . <br /> Elf 00 43 <br />