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ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT # <br />CONIPUTER/PL-RMIT # Mfg .371 S3 (o <br />SITUS/FA;C'ILJITYD <br />ADRESS: 3 70 o -Z L• ��CAil7L1�/Ip l � ZLt ' <br />GU <br />DBA: LP / &2)-r4 ,S -En c ; � I55T <br />BILL TO: <br />BILLING ADDRESS: <br />SfDrL �.l <br />CITY/STATE: '' //�- ��_ ,/ � /� C /- ZIP: O �a 5 <br />PROGRAM: M GAS T TYPE OF SERVICE: 6h � 1 a"a 77 r' lU <br />THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br />NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br />DATE <br />of <br />WEEKDAYLl�EEIu�1IGHT <br />SA,VI- <br />430PDI <br />0Pv1-SERVICE NDS <br />EEKE0 Sl <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS NAME <br />I <br />I <br />TOTALS <br />BALkNCE DUE: <br />BILLING DATE: <br />EH 23 074 (Rev 3/22/91) <br />A <br />