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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT <br /> CO?,IPUTER/PERMIT # i 672 <br /> SITUS/FACILITY ADDRESS: 14"skv CmN', <br /> DBA: <br /> BILL TO: Huskli cmje PHONE 200j <br /> BILLING ADDRESS: <br /> CITYISTATE: ZIP: <br /> PROGRANf: TYPE OF SERVICE: C`/osuJ� �c�lnd/ �i nbi✓ 'ICP✓/4t / <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 /> eopE <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30P.M-SAM/ <br /> SERVICE 430P.VI WEEKENDS <br /> 104 4f�x--" c h1 r <br /> TOTALS �( <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />