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v <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # Z` <br /> L�P7 <br /> COMPUTER/PERMIT # _ - 7SITUS/FACILITY ADDRESS �v / <br /> DBA: Al <br /> BILL TO: �?/ P//G��/r �'✓ t//�o�✓M� � i�L PHONE: <br /> BILLING ADDRESS: _/ / b /7111 L V/r!� <br /> CITY/STATE: ZIP: 7-6 <br /> PROGRAM: TYPE OFSERVICE: �� /�w/ ) "*nVVA-L- (74 -So <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 /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> TOTALS <br /> BAL 14CE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />