Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT ## 1" ,}� (�9LIq <br />CONIPUTER/PERMIT # `►� DO 1 � v v <br />S[TUS/FACILITY ADDRESS: -:::T D I Char �eK <br />DBA: <br />BILL TO: PHONE: <br />BILLING ADDRESS: <br />CITY/STATE: <br />ZIP: <br />PROGRAM: TYPE OF SERVICE: <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 <br />of <br />SERVICE <br />WEEKDAY <br />SA?vf- <br />4:30PM <br />WEEKNIGHT <br />4:30PNI-SA,NI/ <br />WEEKENDS <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS NAME <br />° Z 0 <br />I//D <br />f "bo ` �(; 3300 <br />►� e'"'' <br />ur! art v �' <br />Y471 <br />I l � <br />3 / <br />r <br />TOTALS <br />I3ALINCE DUE: <br />BILLING I)XrE: <br />EH 23 074 (Rev 3/22/91) <br />