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�. `. <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT# <br /> COMPUTER/PERMIT # aS59 <br /> S1TUSlFACILITY ADDRESS: 210/ <br /> DBA: 10o !l lealAe mo6�/t lA2. e Sale-s <br /> BILL TO: Low // to e PI-'ONE: ;2na-9"d'-1077 <br /> BILLING ADDRESS: A /v/ y C6 G,-<e� 4-9�� <br /> CITY/STATE: SI-a ck t" rA ZIP: 9SdOS <br /> tlCoTs, ��lED � � <br /> PROGRAM: TYPE OF SERVICE �an rev e�/�uv�E rtna�u P� ��coo i <br /> THE WNIMUM TIME FOR EACH INSPECTION IS ONE Cl) HOUR, ANY ADDITIONAL. INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF GM HOUR, INCLUDING TRAVEL TIME. <br /> DATEWEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS NAME <br /> of 3AM- 430PM-3AbI/ <br /> SERVICE 430Pb1 WEEMNDS <br /> o?g'"9Z BhVI7-9A�1 v re <br /> O D-,3,,7VYes r.�>f wwc.��-✓ <br /> TOTALS <br /> BALINCE DUE: <br /> BILLING DATE <br /> EH 23 074 (Rev 3/91) <br />