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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> V rI S�t <br /> COMPUTERIPERMIT # <br /> S[TUS/FACILITY ADDRESS: - �_`t S S 4 n , ! 4 s T S 4,C-(L -.* GA <br /> DBA: _ 1�le, 0 CV-� � <br /> BILL TO: ��--�e -7-e b, �'�, r u PHONE: <br /> BILLING ADDRESS: <br /> CITYISTATE: C/4 f ZIP: r z`I <br /> PRO 0RAIM: A (-L�—T TYPE OF SERVICE: P I:.LA ve e .> ,A- <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDI'T'IONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> a.,,y J G��� - lq � 3 �lf,q 3 �j TI'S_ F 63 c, <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WOFrq REHS NAIME <br /> of SAKI- 4:30P:.I-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> t?!ll v 1�1c�'✓ 4 [�L <br /> f ( A-1 <br /> TOTALS J <br /> BALsUNCC DUE: rLhlJ- <br /> BILLING DATE: --� <br /> EH 23 074 (Rev 3/22/91) V <br /> C 03 0-t U, <br /> 0 <br />