Laserfiche WebLink
S' Y <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 1� <br /> COMPUTE ERMIT # ROCi}fl,Zy <br /> SITUS/FACILITY ADDRESS: a2q73 Loorgf5 )2r <br /> DBA: f--/ Roct", Imm-f-ek TrsrNschrfu+fo,� <br /> BILL TO: r-a Aoc�e. S PHONE: <br /> BILLING ADDRESS: 3N E GvAiwifmrer <br /> CITY/STATE: MO dP5fc> ZIP: 9535`/ <br /> PROGRAM: (16ST- TYPE OF SERVICE: lDNS ({�(ivu so+� Scvmnl+we, <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-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> ' q 1 <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: y�y�gf <br /> EH 23 074 (Rev 3/91) <br />