Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # S '4133 <br /> SITUS/FACILITY ADDRESS: fI�a C )dGtiC - Gv 1� CLL , SfL��/l�7ZYV <br /> //� <br /> DBA: / / <br /> BILL TO: 7)' L- . C(�JLcJ <br /> PHONE: <br /> BILLING ADDRESS: IIP�/� S. W ( � G� St. <br /> S o c � <br /> CITY/STATE, ZIP: <br /> PROGRAM: y TYPE OF SERVICE: &0 � <br /> �liylS C�7•l"vf <br /> THE MINIMUM TRa FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDMONAL INSPECTION TUAE 19 COMP= TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. o a � /N d-.r, ` <br /> WEEKDAY WEEKNIGHT HOLIDA S DESCRIPTION OF WORK REHS NAM� <br /> 8AM- 430PM-8AM/ <br /> 430PM WEEKENDS <br /> c <br /> _ _ q SsbC>--ii:3v Wt�vtkdd� Y <br /> d a3 `l ':30 a:3 <br /> -7_ 10'00- (00 <br /> TOTALS <br /> BAL INCE DUE <br /> BILLING DATE e ^ CC)(el <br /> V-Dw <br /> EH 23 074 (Rev 3/22/91) , /l/ A <br />