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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # �� -- <br /> CONIPUTER/PERMIT # I D/! <br /> SITUS/FACILITY ADDRESS: D �X <br /> DBA: P G ¢ 6 <br /> _ <br /> BILI. TO: FAewGCS - PHONE: <br /> BILLING ADDRESS: 2 o- 6ffL)L - <br /> CITY/STATE: I- alL z ZIP: 2-4 <br /> cot <br /> PROGRAM: �t �� � TYPE OF SERVICE: <br /> ✓�✓1�:�-Gtr" -- - ..... <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NE.�.R,EST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> 1)14UU7� ' G�74y1 l ALL k <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTIOf"i OF WORK REHS NAIME <br /> OF 3ANI- 4:30PNI-SAM/ 3 <br /> SERVICE 4:30PM WEEKENDS <br /> P, <br /> r <br /> q1DO I'0'-3e+w i <br /> _ i a.?I o-11,•'� ,� f _Fv. p-�� � ! pit <br /> TOTALS _! <br /> ll,% , NCE DUE: <br /> BILLING DXI'E: <br /> EH 23 074 (Rev 3/22/91) <br />