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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # :Z� 2y�9 <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: Z2I D �.DUY/ '� vl�✓ S te ' "" <br /> DBA: <br /> BILL TO: PHONE: <br /> BILLING ADDRESS: Z�JS � D Driv& <br /> CITY/STATE: �I nn ZIP: ` <br /> PROGRAM: TYPE OF SERVICE: dl/a-y— <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDMONAL INSPECTION Tmm IS COMPUTED TO THE <br /> N HALF (1/ HOUIj,INCLUgING TRAVEL TWE. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS NAME �1 <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> /0,00 - inifZ rev o �,ly <br /> Ul 7 77 /i: 1�.- P, d0 I <br /> Illbo <br /> V s� -fo r-a,�fi(bcfc✓ ✓�6 Lc% <br /> _ ''qZ IT - W ra xov, 4- <br /> 2'•30 s l o / I'sf /Q <br /> ?'Z'qZQ�� ���LV w7, (� l161a <br /> 6-12-q-z- evtw <br /> wY <br /> P. Vf Ir�r f <br /> I <br /> TOTALS <br /> RALINCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />