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ENVIRONMENTAL HEALTH DIVISION (c0 D <br /> ACCOUNTING WORKSHEET �� <br /> UNIT # ,27; <br /> Q �. /00 (0 <br /> COMPUTER/PERMIT # 57OCK 68 � <br /> SITUS/FACILITY ADDRESS: l o 8o3 '56L'6•'� <br /> DBA: AV 6 %((',�P��- {1 '/ r�(��vl �� �1�r „�,�5an �d • I'Ur S <br /> BILL TO: L' D.> `� 1J4�(�i p t7T ��U�I��GI'i l/L�,�✓K�15 � �6hn FvK.cincNE• <br /> (� 205-9�/�1 <br /> BILLING ADDRESS: �y1�2�j /� ' C� �/j9U/ J ✓� l�'nnvm 3/� q <br /> CITY/STATE: G✓' C LCV ZIP: <br /> PROGRAM: VST TYPE OF SERVICE: <br /> THE MINIMUM T[ME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL T2AE. <br /> 3. 0 ko-� 9-ii-9 Z- <br /> �E WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> 8AM- 4:30PM-SAM/ <br /> 4:30PM WEEKENDS <br /> q���O'q Z 10'.30 ^ O I 'ilii d i., i rwt+w e c•p. 5'+►�,t <br /> I I%3 5 fih QiYn /0 <br /> i��G-�i7� �„ -�/'�,•� I'BI�L. h - /mow s/kS <br /> I'L'L �j3 ��:3o ILII ev t")cos I Re{u Ira, <br /> f �/6 <br /> 1 -/23 <br /> TOTALS s <br /> BALANCE DUE: <br /> BILLING DATE. <br /> EH 23 074 (Rev 3/22/91) I U <br />