Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 3 STOc c�� <br /> COIIPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: �a y S G f�Fr Sf <br /> DBA: S�oc/c�r SP/) io ce <br /> BILL T0: _ �� 1/�ccat �i� C-,� ?7- PHONE <br /> BILLING ADDRESS: _ 2121G.q c <br /> CITY/STATE: S1:71 c i G, o <br /> ,l , ZIP: 95-,Pa ? <br /> PROGRAM: TYPE OF SERVICE: 7iizf h•.rrc LwQ a/, /PraccJ /ter <br /> THE MINIMUM TINE FOR EACH INSPECTION IS ONE (1) HOUR ANY ADDITIONAL. INSPEC ION T[ME IS COMPUTED TO <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME, THE <br /> 34m <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NA,NfE <br /> of SAM- 4:30PM-3ANI/ <br /> SERVICE 4:30PNI WEEKENDS <br /> N< <br /> 3 /LrF <br /> .� ems✓ <br /> VuD !US <br /> N2 <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE <br /> IH 23 074 (Rev 3/91) <br />