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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # --9 <br /> COMPUTER/PERVIIT <br /> SITUS/FACILITYADDRESS: �e2q Con,rne%,�� <br /> DBA: o e cc_ �'I C i l-Kl- rr.r fru_ /17 c _ <br /> BILL TO: f911 Lyu N. yiCy PHONE: 7-5- <br /> BILLING ADDRESS: <br /> CITY/STATE: <44 zip: 9S,2 sr 9 <br /> PROGRc4V1:��fS�A� 6/"i%3 TYPE OF SERVICE �/ rs�; ✓ firrf�r ddi Slse �z� <br /> THE iNMVIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITICNAL INSPECTION TIME IS COMPUTED TO THE <br /> N ) HO CLUDING TRAVEL TIME <br /> z 2 i® z <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30PM-3A,W <br /> SERVICE 4:30PM WEEKENDS <br /> wrn�cr cam <br /> l9' 2�1Z I'p0 ' �1� 8v Nwple- resp <br /> fi erwovK � Vlb <br /> TOTALS <br /> BALANCE DUE- <br /> BILLING <br /> UEBILLING DATE <br /> EH 23 074 (Rev 3/91) '` <br />