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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: �Y�00 /�CrJy g� GG <br /> DBA: <br /> BILL TO: PHONEPoz-) 33) 3337 <br /> BILLING ADDRESS: /S/c( dry Ay6daC- <br /> CITYISTATE: /t/F-Y4z>4 ZIP: p f .-43.1 <br /> PROGRAM: 0!3' . SO TYPE OF SERVICE: %� iUK r? i4oyviL j <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 3A?vf- 4:30PYI-SAM/ <br /> SERVICE 4:30PM WEEKENDS wM4� <br /> GdJE <br /> 7�jt q/ //-5oa--/p:o✓� P� LGOSvkt PUQA! REvi� � >JZ <br /> 3:6;r,p, �i � 4 tJz <br /> GEF/,A- <br /> q 19/9 q_ov. .�'*� 14j 4C IA- �AU/Ji�- ?f-`EVF.�cIt�- /.IZ <br /> 9C/9 u / 9=35w —/Z o y 1.21 ymie aeric/ I t�2 <br /> TOTALS <br /> BALUNCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />