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ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT # <br />COMPUTER/PERMIT # <br />SITUS/FACILITY ADDRESS: l "I Q J (✓D Un4n� , a[,U 6- g t vlil , `51—L ? <br />DBA: c) -1 1 <br />BILL TO: J"" PHONE: <br />BILLING ADDRESS: <br />CITY/STATE: ZIP: <br />PROGRAM: TYPE OF SERVICE: <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 <br />of <br />SERVICE <br />WEEKDAY <br />SAIVI- <br />4:30PM <br />WEEKNIGHT <br />4:30PNI-SAM/ <br />WEEKENDS <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS NAME <br />� n a e✓1 �.mr rvw�e. cr� <br />TOTALS <br />IIALkNCE DUE: <br />BILLING DA'Z'E: <br />EH 23 074 (Rev 3/22/91) <br />41 40 <br />