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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 3 <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: do a r ►c ,,., q �� <br /> DBA: 4COA E Sc•w 4 f n aLt 4,jcJ 9L-op l� <br /> BILL TO: `7 D 11v` o K c-,e f---e_ PHONE 2g 7VF X73_. <br /> BILLING ADDRESS: 5 3 y i 14 J-D Jc4z" <br /> CITY/STATE: ZIP: 9 S 2-0-S-- <br /> PROGRAM: <br /> PROGRA : 1P t+3 —5V TYPE OF SERVICE: — cxy\l<- y-erw v o. v e,n LAJ— e4--c-- <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 WEEKDAY WEEKNIIGHT HOLIDAYS DESCRIPTION OF WORK I REHS NAaME <br /> of SA.Nf- 4:30P,NI-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> —� a rt Plan V e v'e LD /\Il <br /> 1 O• 1' , 1 Y'M r h ��ti a . 2 G. i 1>1-;'-Y <141A <br /> /Lo <br /> , <br /> •F <br /> ( <br /> TOTALS <br /> BALkNCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />