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Z <br /> 1 C/ <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> uN IIT <br /> COMPUTER/PERMIT <br /> SITUS/FAC[LITYADDRESS: � c�7U G/- <br /> DBA: <br /> BILLTO: /UTf �G �S PHONE: <br /> BILLING ADDRESS: <br /> CITY/STATE: �A f�/a ZIP: S 3 30 <br /> PROGRANt: 2 3tYU TYPE- OF SERVICE: <br /> T:E MINIMUM TWE FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL. INSPECTION TUAE IS COMPUTED TO Tir.B <br /> NEA.4EST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEK—NIGHT HOLIDAYS DESCRIPTION OF WORK REHS N.PUME <br /> of SAM- 4:30PM-SA:NI/ <br /> SERVICE 4:30PM WEE:CENDS <br /> L <br /> 64-4 I o ie � N t <br /> -IO-y/}2 4 -tO I I eek n t Q- A <br /> ncr4 s <br /> TOTALS <br /> RAL\NCC DUE: <br /> BILLING DA'L'E: <br /> EH 23 074 (Rev 3/22/91) U/ <br />