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ENVIR-wNiVIENTAL HEALTH D1,dSION <br /> ACCOUNTING WORKSHEET <br /> UNIT # r_ <br /> COv(PUTERRPERMIT # Z 7 <br /> SCNS/FACIL=ADDRESS: /7b495. FG6,P,44rj6 <br /> DBA: 7<d�r— 41, z)o~1) -1"jDje /WA7&7_AfENTS <br /> BILL TO: eF'—o,4,ACf.O^ 4/6�37 <br /> PHONE: C2— 7s- <br /> BILLING ADDRESS: 3OX /oz- / <br /> CITY/STATE: �/,o GA zip: <br /> PROGRAM: TYPE OF SERVICE: GGGSv,P ,�,clujEl/ P65,v.ae, /kF� <br /> THE MINIMUM TtME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECITON TIME IS COfsUTED TO <br /> ilniz <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS N.4bIE <br /> oI 3AbI- 4:30PM-3AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> TOTAL <br /> BAL1NCE DUE: 6 <br /> BILLING D,\1'E: <br /> E.'i 23 074 (Rev 3/22/91) <br /> 1 <br />