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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT# <br /> COMPUTER/PERMIT# �S�i t� /,g/// //L�s? _�✓v �O59G/ <br /> SITUS/FACILITY ADDRESS: <br /> DBA: `a <br /> BILL TO: %/� L�}/LD yn/ I�/�b/✓�Oy�(�� J�j�!/�CP� PHONE ��D ( _ �O <br /> BILLING ADDRESS: <br /> CITY/STATE: <br /> ZIP: <br /> PROGRAM: Ste. _ TYPE OF SERVICE: 7/3W�e ��h . e2 <br /> THE MIIGIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR INCLUDING TRAVEL Ta,4E. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTIONI^ OF WORK RENS NAME <br /> of SAM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> J / <br /> TOTALS <br /> RAL,WCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />