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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT# SR 5"77 Jk ` ,57a p <br /> SITUS/FACILITY ADDRESS: <br /> DBA T _Q, [yam <br /> BILL TO: <br /> BILLING ADDRESS: <br /> CITY/STATE: Q ZIP: <br /> PROGRAM: - 3 TYPE OF SERVICE: ' <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE Cl) HOUR, ANY ADDRIONAL INSPECTION TAa IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS NAME <br /> 8AM- 4:30PM-8AM/ <br /> 4:30PM WEEKENDS <br /> TOTALS I ;�/ - „ , <br /> BALANCE DUE 7; % t <br /> BILLING DATE <br /> EH 23 074 (Rev 3/22/91) <br />