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i • <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # ExxoN Z-7 <br /> SITUS/FACILITY ADDRESS: '29rOJ (.L�(// /r <br /> C <br /> DBA: Exxon J`-h h 6p `�'� -'3?6 / <br /> BILL TO: �U�i�4 I� �� � � _ PHONE:{�I 0 qwl 99 47 <br /> BILLING ADDRESS: (100 (-4Az& <br /> CITY/STATE: KZ�'L Glq ZIP: <br /> C <br /> PROGRA1v1: TYPE OF SE-RVICE: t�E tnC✓� �T�Szc 11a �i 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 /> ,4-I D F 4 :Z0 h r5 01101q1 <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> q 3 = <br /> re <br /> �D R/ 06) du) f+ /YLei � V LC-C�f <br /> v '� ( I <br /> TOTALS <br /> BtkLkNCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />