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ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT # /// (a <br />COMPUTER/PERMIT # N141-10ZO 6me # <br />SITUS/FACILITY ADDRESS: 205-0 [Al. rt-6MCf 5*ZZ2' ✓ G� -� <br />DBA: Nchma/ Pdver4t6in4- (AM.00,,.w, <br />BILL TO: KrDPK�`-7Envlr�,/�c�„f,�� 5� ��s PHONES y39-O60S4 <br />BILLING ADDRESS: �z 7 W�y[nu,� p <br />CITY/STATE: ✓e`Jn D e CA ZIP: / 39-O <br />LI <br />PROGRAM. <br />U5T <br />TYPE OF SERVICE: &m6V,-e— <br />THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY <br />NEAREST HALF 2) JiOUR, INCLUDING TRAVEL TLVIE. <br />At -j IG,,- 1-10-cf-2- <br />ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br />DATE <br />of <br />SERVICE <br />WEEKDAY <br />SAN[- <br />430PLNI <br />WEEKNIGHT <br />430P.M-SA,VI/ <br />WEEKENDS <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS NAME <br />Z'- AI <br />Re view ha"iiacL! arF ..o <br />Pam to kijp <br />-31-q2 <br />�Do- <br />2:oo <br />; - PpRco <br />Revi2.+J o res�brviml+4 <br />il <br />-y `1� <br />e•oo 0 <br />2 gIL� <br />r a <br />I <br />ZLjD <br />(7 <br />tlrt o U5T'. <br />yZ <br />3 30 <br />1 <br />Z �J I L L <br />wr rem cvvL <br />I n OlX <br />Too <br />LI✓" <br />tnGw ramp raan� . 1711 <br />Canfa Yn . Nrork <br />I <br />I <br />I <br />TOTALS <br />B.\L\NCG DUE: I I S q <br />BILLING DA'i'C: <br />EH 23 074 (Rev 3/22/91) <br />