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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT ` �L <br /> COiN,f?LTER/PE?.M1T * RAM&50 <br /> SITUS/FACILITY ADDRESS: 502-3 A2 . F1004 PM4 <br /> DBA: Actmacher 4vin ,tk�cjur44 <br /> BILL TO: jlI 7 PHONE: -19-365'-btrys <br /> BILLING ADDRESS: )PO, Box 35? <br /> CrMSTATE: Lin C4 ZIP:tUW-035^/ <br /> PROGRA.m: 06-Sr TYPE OF SERVICE: 0657— T- k closua es <br /> Ti- .MtMMUM TME FOR EAai INSPECI7ON IS ONE (1) HOUR, ANY AMMONAL INSPECTION TME IS COMPUTED TO THE <br /> NE4R_'-ST HALF (1/2) HOUR, INCLUDING TRAVEL TME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30P.M-3AM/ <br /> SERVICE 4:30P,I WEEKENDS <br /> 2 1 I :BD-3'oo I <br /> I I I <br /> I I I <br /> I I <br /> ( I I I <br /> I I I <br /> I I I <br /> TOTALS <br /> BAL%,'gCE DUE: <br /> BILLING DATE <br /> -H 23 074 (Rev 3/91) <br />