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OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIAL MANAGEMENTPLAN FEE <br /> CURRENT YEAR_ CS �o <br /> BII.LING CORRECTION RECORD <br /> Name of Business T c u l-�Z-U ,4 A uJo <br /> PrimaryContact �CkLj e Account No. `fo S 7 <br /> Facility MailineAddress 2( 5- 1 Ccuw <br /> Billing Year That Error Was Made Cl <br /> Amount Originally Invoiced �3 �fJLJs& <br /> Beam <br /> Original Base Fee!Chemical Count V'^ <br /> Type of Error. [ ] Data Entry X Review [ ] Other <br /> Nature of Error 'E— —, o v\ i a:-� ( E , b, CQ vV Le-A <br /> I n6" <br /> Corrected Base Fee/Chemical Count <br /> ®= <br /> Amount Overcharged <br /> Amount Undercharged <br />