Laserfiche WebLink
r <br /> ENVIROMMENTAL HEALTH DIVISION <br /> _ ACCOUNTING WORKSHEET <br /> UNIT # �� <br /> COfNIPUTER/PERMIT # UL-1 <br /> 1� <br /> SITUS/FACILITY ADDRESS: Z <br /> DBA: <br /> BILL TO: IL <br /> S C1'j fjQ/L / O G 71 <br /> FILLING ADDRESS: if <br /> CO12 <br /> f� PHONE: <br /> /r <br /> CITY/STATE: <br /> PROGRAM: U57 ZIP: �(1 <br /> TYPE OF SERVICE: <br /> TFE MINIMUM TIME FOR EACH INSPECT ON IS ONE 1 <br /> NEAREST (1/2) UR, INCLUDING TRAVEL - HOUR, ANY ADDITIONAL INSPECTION TIE IS COMPUTED TO THE <br /> DATE -9 <br /> WEEKDAY WEEKNIGHT HOLIDAYS � V 10 <br /> of SA - 4:30P,vf-3A.&f/ DESCRI.TION OF WORK REHS MAME <br /> SERVICE 4:30P�%q 1VEEICENDS <br /> Z :UO' DU /UT <br /> I3r4L sib nu. drs <br /> tJ'�� <br /> 1VF <br /> l <br /> TOT,:!,, F <br /> R,%L1NCE DUE: .r <br /> BILLING 1)XI*I': <br /> EH 23 074 (Rev 3/22/91) <br />