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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # 145SOC 134A 6,;l 7 <br /> SITUS/FACILITY ADDR��E-SS: �a 3 W, l A Cuc�jti j Co ea t, S�Cr 1. <br /> DBA: ��✓IOCr u-*d <br /> /-► <br /> BILL TO: ss o C f c,_�'d Th azt� ( PHONEr.3b j) .6e-366_S <br /> BILLING ADDRESS: 13 3 " � W, t-&i A-7&& J W c �— <br /> CITY/STATE: S�Ci��y-�Yl� C/-? ` ZIP: <br /> PROGRAM: (/{iG 57' TYPE OF SERVICE: C. / (')C (A )-t� <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 TBvfEO <br /> /L7 3c) ec - . co&ccAg is <br /> DATE WEEKDAY WEEKNIGHT HOLT AYS DESCRIPTION OF WORK REHS NAME <br /> of 3AM- 4:30PM-3AM/ <br /> SERVICE 430PM WEEKENDS <br /> 3 ,30- 1:001 <br /> a! 3C <br /> 11.' 6D Byf�ti��O�SlGm ' -a. Y�l/nv <br /> i sz n <br /> Z 3(7 ev,aw �e s�o.K� 1116 <br /> yfzps <br /> I <br /> TOTALS <br /> BAL\NCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br /> 1► v <br />