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�J 4 <br /> F <br /> ENTIIRONVIENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> WTI' <br /> COMPUTER/PER.[TT # /377 <br /> S7VS/FACILITY ADDRESS: / X/- sive ST Garr <br /> DBA: <br /> BILL TO: 7��YGZ� PHONE:(' <br /> BILLING ADDRESS: 1901-4 Rz:�/6 <br /> CITY/STATE: �aICE� 27 G ZIP: <br /> PROGRAM: !i� !� TYPEOFSERVICE: y'G•l IL1oyiQ� <br /> 'HE VUNR UM TIME FOR EACH INSPECnON IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION ME IS CONQU7-rD TO THE <br /> NE-0—EST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> WEEKDAY WEEXMCHT HOLIDAYS DESCRIPTION OF WORK RE-',IS NAME <br /> 8AM- 430PM-8A.W <br /> 430PM WEEKENDS <br /> rr i711t <br /> °l q Z:oo-3=3°* I.S �(lal�K-�FiF+ov�L F�,2rt. J TlL' <br /> - 5 <br /> �fX.Evc'rJ <br /> 3 2�9 2:Zrj 'Z•' y -- 5oi� , , A _FQrL i.J S <br /> LK�4n1 GE?TE—�L +�E <br /> TOTALS <br /> B. LANCE DUE 5 X ?� <br /> BILLING DATE <br /> E:-T 23 074 (Rev 3/22/91) <br />