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ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT # <br />COMPUTER/PERMIT # ( N �" V � Z / <br />SITUS/FACILITY ADDRESS: <br />DBA: C- hb � / . s �- <br />/; 1 10 <br />BILL TO: �ZirlJ r� (- Z� lr/')'*1 6 �. /j PHONE: t34' -t2-"1 0 <br />1 C� <br />BILLING ADDRESS: i ( r` I L <br />CITY/STATE: Z- <br />�.�.�.t,�.ivv+x?�%a � �� ZIP: <br />PROGRAM: 0 ��/ TYPE OF SERVICE: e-e-1-4 <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 />V E�� <br />DATE <br />of <br />SERVICE <br />WEEKDAY <br />SAM- <br />4:30PNI <br />WEEKNIGHT <br />4:30PM-SAM/ <br />WEEKENDS <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS NAME <br />/� /8 9/ <br />�2j,i5� h <br />meth�,,.� c•v. -a ss <br />V1411p <br />I <br />TOTALS <br />I3ALkNCE DUE: <br />BILLING DATE: <br />EH 23 074 (Rev 3/22/91) <br />