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ENVIRONMENTAL, HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 011�� <br /> COMPUTER/PERMIT # //99 <br /> SITUS/FACILITY ADDRESS: 2�a 5 <br /> DBA: 1 v e[t)Gv-3 &,g& fnl D�. <br /> BILL TO: lye. ,t) I A)C- PHONE: <br /> BILLING ADDRESS: P• D <br /> CITY/STATE: R j pon ZIP: �P <br /> PROGRAM: 0 3-� TYPE OF SERVICE: <br /> THE MINIMUM TMM FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COUYUTED TO THE <br /> ST <br /> (y4) HOUPINCLUDING TRAVEL TIME. <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIP'T'ION OF WORK RENS NAME <br /> 8AM- 4:30PM-8AM/ <br /> 4:30PM WEEKENDS <br /> !2 f :�p- a �/1 h eU C <br /> J'_! <br /> kaC.eNx- e-,�-F- rPtt4kS4�- <br /> 10 0 <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />