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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> WIT # 3 <br /> CONIPUTER/PERIfIT # �Y 96 IL ll <br /> SITUS/FACILITYADDRESS: �/O N /dries lff"' <br /> DBA: e Co.�r� <br /> BILL TO: CA1.2Al N r%/ PHONE: %/!y <br /> BILL LNG ADDRESS: e yd S <br /> CITYISTATE: Coo `;YC. yd ZIP: 9YlvOi' <br /> PROGRAM: ///5 F/1) ;,"'"TYPE OF SERVICE- �r.y Pmwa O ala u rcy fel ��s�c <br /> THE ,WNIMUM MM FOR EACH INSPECTION M ONE (1) HOUR ANY ADDMONAL INSPECTION MAE 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 SAKI- 4:30PM-3AI <br /> SERVICE 4:30P.lvI WEEKENDS <br /> ac.� /Sr1.Ol7' c /d -Y- moi/ <br /> Sinn r <br /> all— <br /> TOTALS <br /> BALANCE DUE <br /> BILLING DATE <br /> EH 23 074 (Rev 3/91) <br />