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r <br /> SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. HAZELTON AVE. , <br /> P 0 BOX 2009, STOCKTON, CA 952.01 <br /> BILL 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 APPLICATION. <br /> SITUS ADDRESS:_ ���r� PERM I'T #� 'e <br /> BILL TO: NAME �5 <br /> ADDRESS ,:2j, WIVZo)< <br /> CITY/STATE - 7` W, ZIF' Sc�O�S <br /> PROGRAM: <br /> DESCRIPTION OF SERVICE(S) : <br /> DATE TOTAL WEEKDAYS WEEKNIGHTS WEEKENDS/HOLIDAYS SANITARIAN <br /> OF 8AM-4:30PM 4:30PM—BAM <br /> SERVICE HRS WORKED X35/HR $52. 50/HR $70/HR <br /> y Oa- <br /> 4,,00-`fE3o <br /> JfOTALS <br /> BALANCE DUE• <br /> BILLING DATE_ _ PAYMENT IS TO BE RECEIVED WITHIN <br /> DAYS FROM THE BILLING DATE . <br /> RETURN ONE COPY OF THIS BILL ALONG WITH PAYMENT , MAKE CHECKS PAYABLE <br /> TO: SAN JOAQUIN LOCAL HEALTH DISTRICT. <br /> EH 00 43 <br />