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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT# 2 <br /> COMPUTER/PERMIT# 8Sa <br /> SITUS/FACILITY ADDRESS: Sal iv. F./6ez� <br /> DBA: ✓c%� l�i4c� <br /> BILL TO: PHONE: y -?( e-(o/7� <br /> BILLING ADDRESS: <br /> CITY/STATE: L o ol: CA ZIP: 9s-d Y/-o3 c 7 <br /> PROGRAM: d/ea;f— TYPE OF SERVICE: <br /> THE MINIMUM TZE 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 Ni <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> 3 <br /> -'// / <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />