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ENVIRONMENTAL HEALTH DIVISION 6,r <br /> ACCOUNTING WORKSHEET <br /> UNIT # -2 t- <br /> COMPUTER/PERMIT # An�'-lz � <br /> SITUS/FACILITY ADDRESS: Z61,75D Zl.--Ime J �- ���- 7 <br /> DBA: <br /> BILL TO: ® // PHONE: �6 6 7- <br /> BILLING ADDRESS: , o <br /> CITY/STATE: I ZIP: �S <br /> PROGRAM: Ulr`/ T TYPE F SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPEC ON IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUD TRAVEL TIME. <br /> DATE W�30'iM <br /> KDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 84:30PM-8AM/ <br /> SERVICE 4WEEKENDS <br /> %3o-q Os /fin >G thv �i'e ✓/ems G✓ <br /> /Q 7 / Vc- <br /> f3 Dere Fa /2 (://7cl <br /> TOTALS <br /> VALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />