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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # -y <br /> COMPUTER/PERMIT # :L EU 30 <br /> SITUS/FACILITY ADDRESS: 3a P 7 If, M a i+ 340'44r C�o <br /> DBA: A O <br /> BILL TO: carne /- s PHONE: ,0 n 9-&Z-jwl <br /> BILLING ADDRESS: 9 9 7(, Na z e� A� <br /> CITY/STATE: S�v�l�ri"� �� ci Sa/o2 ZIP: /-I <br /> uf7T f2'IJ'+N/#��/an/.R'lihJ,ins�L�ivro� <br /> PROGRAM: TYPE OF SERVICE: k7g,4 5-n <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-SAM/ <br /> SERVICE 4:30PNI \VEEICENDS <br /> 6�Nli& -/c7 / n r Pv.ell) Q-0 <br /> 3o <br /> C N� <br /> 7��19 A -t�2 8Yv ; 3 rex�. i•5 J�^ Ail <br /> / G y3 3o- YP o �:r <br /> N l <br /> 1ptoo-a'•oo - P �•, <br /> filti, <br /> z o: ► <br /> TOTALS <br /> BAL\NCE DUE: J � / <br /> MILLING DA1•E: i U 0f�` "j 1 7L <br /> EH 23 074 (Rev 3/22/91) <br />