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• ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # Z J <br /> COMPUTER/PERMIT# Z N 6G <br /> SITUS/FACILITY ADDRESS: 2 3 7 5fpj A—n/T <br /> DBA: l'S'�.>4-n!'f Li N P S>1e l-- <br /> BILL <br /> iBILL TO: G—f A q�,(La r1 q-, PHONE: <br /> BILLING ADDRESS: I UV , S'r <br /> CITY/STATE: ZIP: ` <br /> PROGRAM: l) G--S-T TYPE OF SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE Cl) 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 8AM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> o <br /> EXC. , <br /> `1-17-` 1 ` "-12� <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br /> i • <br />