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ti <br /> SAN JDALILIIN LOCAL HEALTH DISTRICT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 1601 E. HAZELION AVE_. . <br /> P O HOX 2009. STOCK:TON. CA 952Xi1 <br /> HILL f-OR SERVICES RENDERED- <br /> TIME <br /> ENDERED 'TIME MINIMUM FOR EACH INSPECTION-1 HOUR. ADDITIONAL INSPECTION TIME <br /> WILL BE COMPUTED IO NEAREST 1/2 HOUR INCLUDING TRAVEL TIME. <br /> NOTE: PRIOR TO ALL INSPECTIONS. CONTRACTORS ARE REQUIRED TO GIVE NOTICE <br /> AS SPECIFIED ON THE PERMIT APPLICATION. <br /> SITUS ADDRESS:X61 g �tPr D PERMIT # a- IM <br /> �yr <br /> HILL. TO: NAME , <br /> ADDRESSJ„ YI <br /> i� <br /> CITY/STATE ZIP,,,--./ <br /> PROGRAM: <br /> DESCF:IPTION OF SERVICE(S) : <br /> DATE TOTAL WEEKDAYS WEEKNIGHTS WEEKENDS/HOLIDAYS SANITARIAN <br /> OF BAM-4:3iQPM 4:3OPM-BAM <br /> SERVICE HRS WORKED $35/HR $52.50/HR X70/HR <br /> - - -- -- <br /> ` JFOTALS <br /> BALANCE DUE: <br /> HILLING DATE _ _ _ FAYMENf I5 fO HE RECEIVED WITHIN <br /> 7,(-3 DAYS FROM THE_BILLING DATE. <br /> ly RETURN ONE COPY OF THIS BILL Ai-UNG WITH PAYMENI . MAKE CHECKS PAYANLL <br /> f TO: SAN JOAQUIN LOCAL HEALTH DISTRICT . <br /> EH 00 43 <br /> F <br /> r <br />