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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # O . �bmv REe <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: <br /> DBA: �b�IC C ��pZ✓ <br /> BILL TO: _ c 1 hi •b�- S+Dc,Pioel PHONE: <br /> BILLING ADDRESS: y,.`� <br /> CITY/STATE: S 1 c, Kj5V-1 ZIP: ,75202 ' IqV <br /> PROGRAM: 46(e y TYPE OF SERVICE: 5r-LYnpl i.a4!i <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 WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AIYI- 4:30PNI-SAM/ <br /> SERVICE 4:30PNI WEEKENDS <br /> c1'•2�•`� 2 �r Scam C.o t�tc o� <br /> q.2R• 2- e,e. atter r h <br /> bill "` <br /> TOTALS <br /> 11AL%NCE DUE: <br /> BILLING DA'I'S: <br /> EH 23 074 (Rev 3/22/91) <br />