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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 3 <br /> COMPUTER/PL-RMIT# <br /> SITUS/FACILITY ADDRESS: 1 aJ`-I fE . ✓1'L c..r <br /> DBA: i� Me Salo 4 1� cku %4vtcJ pp l <br /> BILL TO: 3 Oki L� oKce -h-F-e- PHONE: oOq-9t�-(o73� <br /> BILLING ADDRESS: 5 3 y L I-}a. w � ocl JC4o� RSZD-= <br /> CITY/STATE: 5+0c lour j CA ZIP: 452�S <br /> PROGRAM: )Pt+-% R3- 9V TYPE OF SL-RVICE: w-D- e4-c_ <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> —1 let 3 —`tom plan Yev.Rc'D /w <br /> 1',u.- ��r�� p <br /> 153 I0I1 — m�� ye c�> <br /> t.&l rule <br /> a'06" `'° � /mac <br /> TOTALS <br /> BALkNCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />