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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 1�- <br /> CONIPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: LY-1 7 <br /> DBA: --h P_ l .CPS' /1-� <br /> BILL TO: _ SE fmC o PHONE: (200 5.1 -yG53 <br /> BILLINGADDRESS: �31_q J0, 7GC/� J�CsL- <br /> CITY/STATE: `Y�/� o(XO.S o� � l`f ZIP: 9 <br /> PROGRAM: � � S � TYPE OF SERVICE: 1 CLyLYK. �Q� <br /> a3 <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME is COMPUTED TO TH-a <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TWE. <br /> s <br /> DATEWEEKDAY ' EKNIGHT HOLIDAYS ESCRIPTION OF WORK REHS NAME <br /> of SA,�I- 4:30PM-SA,�I/ <br /> SERVICE 4:30PiM WEEKENDS <br /> '�"�a I,3:3o-'t.30 r&V , ew <br /> 8830- 9;3 h°xye�eP� <br /> I <br /> DD <br /> i <br /> TOTALS <br /> B,%LkNCE DUE: <br /> BILLING DA'Z'E: <br /> EH 23 074 (Rev 3/22/91) <br />