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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERNIIT # '5ft)GK <br /> SITUS/FACILITY ADDRESS: �� P D JaVr Dn\X,-- <br /> DBA: Oil u <br /> BILL TO: PHONEr- <br /> BILLING ADDRESS: <br /> CITY/STATE: Y bYl_ � __ ZIP: <br /> PROGRAM: U�T. TYPE OF SERVICE: A?216�� <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 TIM'. <br /> • hr:5 513 <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS NAME <br /> of SAM- 4:30P,NI-SAN[/ <br /> SERVICE 4:30PNI WEEKENDS <br /> (v !3 1 - 0- <br /> "A o <br /> 1 ' <br /> TOTALS <br /> MALINCE DUE: <br /> MILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />