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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT #F IIG <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: Z l I.7 ir- <br /> DBA: .t4_-rL-D C_ 4fi2xJC�NZT <br /> BILL TO: l7/Lf012 d.3L- =7� 2.5 <br /> BILLING <br /> BILLING ADDRESS: 3! /���4AI A-D <br /> CITY/STATE: I-OD-L -� GA Zip: 7 <br /> 74n/K <br /> PROGRAM: Z 5. ZZ TYPE OF SERVICE: 1QF✓*ov/F( AEcjll6w Few. uA <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> vEN <br /> I 6�'1G N <br /> o /qf� <br /> �P Zy, �_� G�vSu v T F�fLVEM/L <br /> �i/Z/G( '-� J^I/�ry tel"prRNttN1WO <br /> VAll / ►=N5 e:rS.w GEsl�rlsN6 bT�iJri C �/PIL <br /> /eF�wR� tETTE � �cJ� <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />