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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 13 <br /> COMPUTER/PERMIT# /5a� <br /> SITUS/FACILITY ADDRESS: o ro clw <br /> DBA <br /> BILL TO: AARr F PHO C7U7 37y <br /> BILLING ADDRESS: 1,D 1-,�?oA� _3(09 <br /> CITY/STATE: -Ad Vtsar r-14 ZIP: 07 7 -76t�r� <br /> PROGRAM: m all TYPE OF SERVICE. - <br /> rr cS <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 TIME. <br /> DATE WEEKDAY WEEKNIGHTrHOLIDAYlS DESCRIPTION OF WORK QSNAME <br /> of SAM- 430PM-SA.W <br /> SERVICE a30PM WEEKENDS <br /> W <br /> .uo� 3 jn i 10 At cI <br /> 4 �i� i0m- 30 i.r G i7 rP iie�J <br /> NI <br /> a r� <br /> re >lnl- IV I <br /> TOTALS <br /> IIAL,NCE DUE: <br /> BILLING DATE <br /> EH 23 074 (Rev 3/91) <br />