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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # N <br /> COMPVTER/PERMIT # '/0 <br /> (23 �� [ <br /> SITUS/FACILITY ADDRESS: y0 Z w <br /> DBA: <br /> BILL TO: PHONE: <br /> BILLING ADDRESS: <br /> CITY/STATE: '/c7- {� Q ZIP:' <br /> PROGRAM: V JTYPE OF SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDPTIONAL INSPECTION TIME IS COMPUTED TO THE <br /> (1/2) HOAING TRA IT <br /> (�GI <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIP'T'ION OF WORK REHS NAME <br /> 8AM- WEEKENDS 430PM WEEKENDS <br /> 8;157 . 7 evccon}rs . oS✓6 <br /> �j� �b , i5 <br /> 9��0-l0:�o rh vim, secs <br /> JII �I I :30 - D• �o � w Ne ' +o <br /> 3 '28"�Ir` woo-17'.30 <br /> '1 IO:oo'Ib:3ov�t¢ � 5 <br /> w N•I. caQ -h� <br /> TnTar s <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />