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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> CONIPUTER/PERMIT # — f '�1'1 C' L+ <br /> SITUS/FACILLTY ADDRESS: I t•' ,� %t <br /> DBA: J_4V .�' <br /> BILL.. TO: � � � CT r) PHONE:00b )�4` " <br /> BILLING ADDRESS: &� <br /> CITY/STATE: t ZIP: `7 <br /> PR0GRANL: c:�3, 6 TYPE OF SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMMUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKINIGHT HOLIDAYS DESCRIPTIO OF WORK RENS NAME <br /> of SANL- 4:30PM-SAKI/ <br /> SERVICE 4:30PNI WEEKENDS <br /> 3-/ 7- <br /> —Li%.�3o <br /> 1"3o-3',3-0 <br /> j;3o —aL: 3o <br /> - go <br /> I <br /> `30�3 :OIO <br /> O <br /> � fc' <br /> TOTALS h�' , <br /> _77 <br /> [3t+ LkNCE DUE: AGI <br /> BILLING DATE: <br /> EH 23 073 (Rev 3/91) <br /> i i <br />