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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> uNrr# __ ? <br /> COMPUTER/PERMrr # 60L <br /> SnUS/FACILrrY ADDRESS: r cL S� <br /> DBA /1/C�Gr/c SiPiry l�. oFr ��ur� <br /> BILLTO: //7/lce leoo F¢- /u,"c a, PHONE: <br /> BILLING ADDRESS: ,FO D Cli ur c Li <br /> CrFv/STATE: CIO ZIP: Q S o , <br /> PROGRAM:eaVjort sr 0aV4 EOFSERVICE: Fi¢,�o rPSnirtQ� in��sfiva�s� > �°Pu�d /��w� <br /> THE UYIMUM TUBE FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIIAE IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TARE. <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> 8AM- 4:30PM-SAM/ <br /> 4:30PM WEEKENDS <br /> ,Cej�vt7° fe �vn <br /> TOTALS <br /> BALANCE DUE y 2-9 , <br /> BILLING DATE- <br /> EH <br /> ATEEH 23 074 (Rev 3/21/91) <br />