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ENVIRO-N-"-,lvSENI'AL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # J2� <br /> COMPUTER/PERMIT # LJl�D ID c�J�?J C <br /> SITUS/FACILrrY ADDRESS: Jl 7 S_ ji✓ �l�! i4 F�>2 V a �%G�{G- <br /> DBaNAFE�l1ei <br /> Dn7 <br /> ' <br /> I <br /> BILL TO: V`I 11 M I L!- 5 PHONE #- b <br /> BILLING ADDRESS: <br /> CrrY/STATE 1_ r�,� 1�-- - ZIP: <br /> PROGRAM: 'V �� TYPE OF SERVI F- 4y 1 G UJ , I vw�O�l (r E0 (� <br /> 1) HOUR,i TFOR IME r-.ACH INSPEC710M IS ONE � CO <br /> Ty <br /> ( UR, ANY ADDITIONAL INSPECTION TIME IS CONTPU1cD <br /> NEAREST HALF (1/2) HOUR, INCLUDING GAVEL TZAEE. / '/ P <br /> DATE WEEKDAY WEEIG`riGiiT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 430PM�3AW <br /> SERVICE 430PM WEEDS <br /> , <br /> FN-5-y-- <br /> =TOTALS <br /> r- o r°_ -5 P ` YJA- <br /> ro <br /> BAL4iNCE DUE: <br /> BILLING DATE: <br /> F-H 23 074 (Rev 3/91) <br />