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i <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET (C © �y <br /> UNIT# -3 <br /> COMPUTER/PERMIT # as67 <br /> SITUS/FACILITYADDRESS: ,P73S IV, Teeeee Dr. S'CA-Z& A <br /> DBA: <br /> BILL TO: C�l� S1 �� � ,�1ot,i , / Vc . PHONE �u9 9 /fr- bid / <br /> BILLING ADDRESS: a ? z s %rr�re s> s <br /> CITYISTATE: ZIP: <br /> PROGRAM: UG TYPE OF SERVICc: ee „ eeO ell) <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONALINSPECTION TIME IS COMPU'i"r.D TO THE <br /> NEAREST HALF (1/2) HOUR. INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAKI- 4:30PM-SAM/ <br /> SERVICE 430PIvi WEEKENDS <br /> Phu o <br /> 7/ / /J°FO_y/h I ✓ movAQiii��io� <br /> /5-/9 13 -/y YJ I TG Lc w.���yannv zX— I �C-�JG <br /> 8/�G✓9 L el,p 30 A i? d-fvC� ✓ c(...,� /Lfir+.�� <br /> S 54— le ary Y:,t <br /> TOTALS <br /> BALANCE DUE <br /> BILLING DATE <br /> EH 23 074 (Rev 3/91) <br /> I <br />