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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # _ <br /> CONIPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: <br /> DBA: <br /> BILL TO: P IMAG7 PHONE:`. 3 `5all <br /> BILLING ADDRESS: a � <br /> CITY/STATE: lee <br /> ZIP: <br /> PROGRA��I: TYPE OF SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HAL I (1/2) HOU INCLUDIN TRAVEL`T�IME,�j <br /> c J]' Cif W7 <br /> DATE 1VEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS NAME <br /> of SAM- 4:30PaNI-SAM/ <br /> SERVICE 4:30PNI WEEKENDS <br /> - It <br /> g r <br /> l6- YO ew <br /> TOTALS <br /> TIAL. NCE DUE: � <br /> � ! � _ <br /> EH 23 074 (Rev 3/22/91) <br /> i <br />