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1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> uNrr # 3 -%�/vs-o <br /> COMPurER/PERMrr # S%�1291K <br /> j1 a CHa�+er coo <br /> SITUS/FACILrrY ADDRESS: <br /> DBA: C` -, - ,Le L4' JOSC Lc,o(a l 4. 7 AL �o�v � . Le. ah Ad n <br /> BILL TO: J O k r Le ran PHONE No Y �/d S"8(a7b <br /> BILLING ADDRESS: P- o , t3ux 7g ti <br /> CITY/STATE: Sunk Cru -e- CA ZIP: 9 S Ob I <br /> PROGRAM: UO ST TYPE OF SERVICE: oIr nTy eV c, iv S_yec��^i �-yg <br /> THE MINIMUM TIba 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 /> or�e� i ia-A <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> 8AM- 4:30PM-8AM/ <br /> 4:30PM WEEKENDS <br /> 10 13 c Am-II2• V% "kileo <br /> h N 1 <br /> R3o 30A-Air 0,$�y.hw.pd� <br /> ie -woo <br /> 2, <br /> $ '/z '3 30mn w S V. p Vl <br /> TOTALS L = S.S 7) " 773 <br /> BALANCE DUE ' 7 3, <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br /> i <br />