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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PER.Mrr # <br /> SITUS/FACILITY ADDRESS: <br /> DBA n 3 C r� ) <br /> rl (1�L W O PHONE ' -5-'11o36 <br /> BILL TO: <br /> BILLING ADDRESS: nn0 C^^, Ij/Wc <br /> / <br /> CT /STATE: sAb G lx/`/- <br /> ZIP: <br /> PROGRAM: . TYPE OF SERVICE: <br /> GL1 .�MC'fJ`dti�J <br /> THE i UNDAUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY <br /> NEAREST <br /> DITIONAL INSPECTION '['IME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TME. <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIP'T'ION OF WORK REHS NAME <br /> 8AM- 4:30PM-8AM/ <br /> 430PM WEEKENDS <br /> Re r <br /> Y <br /> bi /li - ou sft.-" <br /> eea <br /> 14' <br /> r vN trJ e <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />