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A <br /> ENVIRONMENTAL HEALTHIII <br /> ACCOUNTING WORKSHEET <br /> UNIT # -LLL— <br /> COMPUTER/PERMIT U N iD-A) 17 <br /> SITUS/FACILITY ADDRESS: I j On <br /> DBA: <br /> BILL TO: PHONE: <br /> BILLING ADDRESS: 4 l 1 t J <br /> CITY/STATE: L o, nc��e S f'� ZIP: <br /> PROGRAM: 23 60 TYPE OF SERVICE: r ""t"'ec e,-LIO, <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 `YORK REHS NAME <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> Z- !30-2:32) ee_ AS a t <br /> i <br /> TOTALS <br /> BALANCE DUE: ?rQ <br /> BILLING DA'1'Ii: <br /> EH 23 074 (Rev 3/22/91) <br />