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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # _ , # <br /> COMPUTER/PERMIT�#^ Z q9 W 7 <br /> SITUS/FACILITY ADDRESS: <br /> %ufiT /i an 1� aO,J <br /> DBA: ! _ <br /> PHONE: 9 -33 <br /> BILL TO: 1 0r1 KK Q <br /> BILLING ADDRESS: �z� 1\I h� <br /> ZIP: 5Zo S7 <br /> CITY/STATE: <br /> PROGRAM: 1/5T- <br /> 1 TYPE OF SERVICE: ���n� <br /> THEA MINIMUM PTIME FOR <br /> EACH H INS NG ION IS ONE (1) HOUR , ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> ST <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> sp <br /> h r z /n rl i reu�w o laa� <br /> ©o <br /> to Y r � a l�lo <br /> l0 30 ,�� <br /> 11 RI io.�s �A4 a5 Aga. et U <br /> 1o ;do <br /> TOTALS <br /> 13ALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />