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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 3 <br /> COMPUTER/PERMIT # o/v <br /> SITUS/FACILITY ADDRESS: <br /> DBA: �tcvw.>,�c� euJa /�-.c•�� <br /> BILL TO: �J ; hQ� PHONE: Plop-V67-Go u) <br /> BILLING ADDRESS: �D wK /7.j7 <br /> CITY/STr%.TE: S/v ZIP: �1os <br /> PROGRAM: llF1-(�f/s) TYPEOFSERVICE: ,ivakc/vScua ia�/liar /kn�alty�i� ` <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR. ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR INCLUDING TRAVEL TIME. <br /> pad s x a 3y = 15- ///P-5 <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> uF SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> Ya 3 �P/n-r3�jh / olo^ revleL,) NL <br /> 5 y -y 30P •37 �� AAF <br /> $/I(//y3 /0 30/4-// <br /> �l f O // I %ua/ r� I d- Ill Z <br /> a <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />