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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> CONIPUTER/PE-RMIT # <br /> SITUS/FACILITY ADDRESS: . S �nc.I-kn . <br /> DBA: Pne( � l nrj <br /> BILL TO: m morOL-t :(zo5 !s6g -6175 <br /> r <br /> BILLING ADDRESS: <br /> CITY/STATE: ec �j� - 95zy/ - o3s7 <br /> PROGR?.N1: CC) <br /> TYPE OF SERVI U <br /> ` i <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) �� � CAPU-[ED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. w � <br /> DATE WEEKDAY WEEKNIGHT HO EHS NAI <br /> of SAN[- 4:30PNI-3AM/ <br /> 3w, <br /> C /� <br /> SERVICE 430PM WEEKENDS <br /> L6 a/ - 0,cO <br /> /v <br /> 0 2-7 sI 4066;� o f w , fay N I <br /> a <br /> 0- /Apm, <br /> TOTALS <br /> L) �� <br /> BAL\NCE DUE: 3/y(/ `J 3 = 15? <br /> d <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br /> V <br />