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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT <br /> COMPUTER/PERMIT # 3Z <br /> SITUS/FACILITY ADDRESS: �d� S' lihL�.eo�c 'v GbDS Sy�y <br /> DBA: <br /> BILL TO: L�EY�S �Nli^ GG�� � PHONE: <br /> BILLING ADDRESS: <br /> CITY/STATE: ��iC�Si� T �a�� ZIP: <br /> PROGRAM: Z3' TYPE OF SERVICE: <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 TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 3AbL 4:30PM-8AM/ <br /> SERVICE 4:30Pb4 WEEKENDS <br /> f7 <br /> 3/3/ 53 N ! <br /> ,I/, 30 0�+- Y m/5 3 0 <br /> � <br /> A IES-,-F-4 E oIL'` c ✓ I <br /> FAY. 5011- <br /> 6.65�'�9 F,Qory - 1G <br /> - El <br /> AriN wAArF <br /> 1-E-rIFQ /1 F+p"1 6v6 <br /> TOTALS <br /> BALANCE DUE: <br /> (TILLING DA'I'L: <br /> EH 23 074 (Rev 3/22/91) <br />