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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT #� <br /> COMPUTER/PERMIT# <br /> SITUS/FACILITYADDRESS: <br /> DBA: <br /> BILL TO: PHONE:��t17S�Bd� <br /> BILLING ADDRESS: a • �aX 957 <br /> CITY/STATE: 22 ZIP: �i5zg <br /> PROGRAM: 2/-eeZ— TYPE OF SERVICE: A-It; 66' / <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 RENS NAME <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> 514` N / <br /> /7 �T C�Ov• i� �� <br /> Z2l r•as-Z�y `(`� l� <br /> RAL�NCE DUE: 111 <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />