Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # /a� <br /> SITUS/FACILITY ADDRESS: _,'IfY f / /(�n1,®L{�f�. TUGKSysvcJ <br /> DBA:-(-Sm-z/ f cS0/1/S <br /> BILL TO: PHONE: <br /> BILLING ADDRESS: <br /> CITY/STATE: 2 ZIP: <br /> PROGRAM: A 3, 6b TYPE OF SERVICE: _ Y`e M D U � � �(p/� rE'UiP6C) <br /> mfr 's 0 ecfi`4>-lS_ <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE Cl) HOUR, ANY ADDITIONAL INSPECTION AIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> uF 3AM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> aa2�'969- -9:00-y'3o <br /> ac <br /> a_ a9;oo-lnIOD f2eUiCw 6 <br /> o o-IA,3 t enur�a e *_ <br /> i <br /> TOTALS <br /> MALkNCE DUG: <br /> MILLING DiVrE: <br /> EH 23 074 (Rev 3/22/91) <br />