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Qb <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # �T <br /> COMPUTER/PERMIT # S N 6 q <br /> SITUS/FACILITY ADDRESS: <br /> DBA: Li Nf, <br /> BILL TO: Rei- r=o\-.P�y, IV PHONE: <br /> BILLING ADDRESS: I W , r S-r <br /> CITY/STATE: A724T/N- �S�T (/�'� I ZIP: <br /> PROGRAM: Q C--S-r 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 WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-8AM/ <br /> SERVI 4:30PM WEEKENDS <br /> e <br /> 13 D-2 'M M�- <br /> `rl y G- Ply, I S N"<, <br /> cy3N/4' <br /> AA <br /> a <br /> :30- <br /> Vk <br /> 7-7 <br /> \ d—VLI Vv- <br /> d t <br /> �G <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />