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ENVIRONMENTAL HEALTH DIVISION <br /> 4 ACCOUNTING WORKSHEET <br /> uNrr # <br /> COWLTTEMERI IT# _amu Kh S( /fid/S <br /> SMJS/FACILrrY ADDRESS: <br /> DBA- <br /> BILL <br /> BA BII L TO: PHONE: <br /> BILLING ADDRESS: sf S lf' /4Uc� <br /> - �q v � <br /> CC=/STATE: I� C� G��( i ZIP: sago 1 <br /> PROGRA.Vf: 02 3 ED TYPEOFSERVICE N -IZ/X�riUC `j�i"d rJ f c�6t,Q SlQ-yk��Q1,i q <br /> ice_ V <br /> iiE �tNMM UM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION lIIa IS COMPUTED TO THE <br /> NE10EST HALF (1/2) HOUR, INCLUDING TRAVEL TMM <br /> S a rfi . ! f <br /> l <br /> WEEKDA WEEKNIGHT HOLIDAYS DES ON OF TORK REFS NAME <br /> SAM- 4:30PM-8AW ` <br /> 4_30PM WEEKENDS <br /> WS-M a:3° ievrucv �p Q <br /> v5 d�"u <br /> 30-4� lo:oo- n`•oo Revs t..a.h � <br /> iI <br /> TOTALS �y <br /> BALALNCE DUE- <br /> BELLING <br /> UEBILLING DATE <br /> f <br /> EH 23 G74 (Rev 3/22/91) II <br /> r <br /> i <br />