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e� <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ��' ACCOUNTING WORKSHEET <br /> UNIT #� <br /> COMPLITER/PERMPC # <br /> SITUS/FACILITY ADDRESS: <br /> DBA: 5 � <br /> BILL TO: PHONE: <br /> BILLING ADDRESS: <br /> CITY/STATE: ZIP: <br /> PROGRAM: TYPE OF SERVICE: <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 WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 3Ai%4- 4:30PM-3AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> ZG Q( Pi�Tfl /\/G �f/du� U amt EGII //46U X177 <br /> q:oo-lD'�►- �il?>!/°� /.E�6W ��P�'1�6t�iL <br /> ,2 <br /> g) Z .DJ'2-�o <br /> o F• �I'�FvFi�-Y <br /> O G 10=3D-/1:30 <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />