Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET ���'" <br /> UNIT # )2�17 ry <br /> COMPUTER/PL-RMIT # I �3CCryS �J� b n <br /> SITUS/FACILITY ADDRESS: r1 D D 1/�� • <br /> Y <br /> l�/yfs(r <br /> �4 > <br /> BILL TO: wlQ _/ill r��J ,ji �(� n PHONE: <br /> BILLING ADDRESS: / SC /V CL -sl-n (i6 A Ly, <br /> CITYISTATE: ,D �D//y�� ZIP: <br /> PROGRAM: ���_ TYPE OF SERVICE: TLQiV�YL <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL, INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) H UR, INCLUDING TRAVE TIME. ao <br /> / �s — <br /> DATE WEEKDAY V KNI HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAKI- 4:30 AM/ <br /> SERVICE 4:30PNI N S <br /> V r <br /> i <br /> TOTALS p� S <br /> BALINCE DUE: <br /> BILLING D.VrE: <br /> IUA IR 5315 0 #13 a�5—& , <br /> EH 23 074 (Rev 3/22/91) <br /> `/ -mol <br />