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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # . _ ZT- <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: 16 76- �. B;a gi c,i R� <br /> DBA: 3,Lde <br /> e �R Df�fS� . L <br /> BILL TO: �� ��/�F / /4/Qilil(i Ck//l2PAr�7�- (I�S /JP?Pryt(i,PHONE:(lr((0 34 76-oBILLING ADDRESS: !� Y <br /> CITY/STATE: ZIP: GP <br /> PROGRAM: C� 3' !RD TYPE OF SERVICE: t"e Mtr)c /�� <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 <br /> _ {( � <br /> DATE WEEKDAY wEEKNiri4r HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SANT- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> .2;00 -3:30 f, <br /> � bwr2 ..liv <br /> 43 ,00— •0Ol - <br /> i <br /> TOTALS 5 <br /> BALkNCE DUE: s <br /> BILLING DATE: T o F,3 <br /> EH 23 074 (Rev 3/22/91) <br />