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40 0 so <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT �✓�5 # yNiaN 3 <br /> COMPUTER/PERMIT # /M/ <br /> SITUS/FACILITY ADDRESS: �/3r1 E- M ger <br /> DBA: 1 r/ <br /> �a &7-7/ o <br /> BILL TO: y fl5soua7s PHONE: 5y!: --yet—gS90 <br /> BILLING ADDRESS: m #sem 1137 4. file&ft,,cP.QV,� - <br /> CITY/STATE: °� G9 ZIP: 9 f9 g5' <br /> PROGRAM: G//�C23-90 TYPE OF SERVICE: Uc-si" r e.movc.e D ka.j rwvrew <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 TME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WOR{ REHS NAbIE <br /> of SAM- 4:30P.M-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> '1 :Oa ✓2n+ C' A07 <br /> o:an -//:oa I. ra k Uel c N.r <br /> I Z X!00-11:319 1--m iv MAW ad C• AIT <br /> O;do R)Oti .Susi /a 11/R <br /> llp� 515 <br /> Leo //,-gm >�` 6W /ems lctiw� /v7— <br /> TOTALS 5 <br /> BALANCE DUE. <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />