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ENVIRONMENTAL HEALTH DIVISION <br /> � ACCOUNTING WORKSHEET <br /> UNIT# L SX Zj7 L/L12 <br /> COMPUTER/PERMIT # d Z 114 l� <br /> SITUS/FACILITY ADDRESS: `� ! O I S, Gni 2is/�L/9-N �- /,V <br /> DBA <br /> BILL TO: L- 6, IJ <br /> BILLING ADDRESS: <br /> CITY/STATE- 5 <br /> ;AAw �A'!✓l D �✓l -�y��� y ZIP: <br /> PROGRAM: J(T71 TYPE_ OF SERVICE: I ►T1`��L 1 �/1M 0 ✓tel <br /> THE MINI [UM TAQE FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. Pd <br /> 2 IJ.ps <br /> DATE WEEKDAY WEEILNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-BP.M/ <br /> SERVICE 4:30PM WEEKENDS <br /> G� - x/17✓ /f/k <br /> TOTALS <br /> HALWCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />