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ENVIRONMENTAL HEALTH DIVISION <br /> -�^ ACCOUNTING WORKSHEET <br /> UNIT # J1L <br /> COMPUTER/PERMIT# R/7 LIQ V�G112 # <br /> SITUS/FACILITY ADDRESS: / -!/0 Z 17&/h �n <br /> DBA: _ �< ( <br /> BILL TO: c_✓��r PHONE: `7 ` -9 3�3 <br /> BILLING ADDRESSC:� 2 OWEA v I • ' O 6 d J <br /> CITY/STATE: 11CX K� �J C �Q 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 8AM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> rhrn o 5 <br /> 0 9 41 oo Al1> fnr su er a.�op remave- <br /> 4m1116 <br /> Aoki, <br /> G. 10 % wow P ��` <br /> TOTALS <br /> BALkNCE DUG: <br /> BILLING DA1T: <br /> EH 23 074 (Rev 3/22/91) <br />