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ENVIRONMENTAL HEALTH DIVISION- <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT# P/9RR I 4 /,310 -/ <br /> SITUS/FACILITY ADDRESS: D6 l c�lOYtJ <br /> DBA: �f� R i S ff Ani Qyi <br /> BILL TO: r L1 ,�e�v �l � $ Ci (' l/� 1 PHONE: <br /> BILLING ADDRESS: �. D� !�`� X �tJr' Q <br /> CITY/STATE: c 4a ZIP: <br /> PROGRAM: TYPE OF SERVICE: o j�ye� plc) 4- <br /> a G3_r S C-7 C9�� <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY AIlDITIO�IAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> L <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIP41ON OF WORK REHS NAME <br /> of SAiNI- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> C. 0O.--3 ; revs ,A 5-SO <br /> 00 <br /> :3D--- AFI a GUr T2 . <br /> AN <br /> op <br /> r <br /> TOTALS <br /> BALkNCE DUE: <br /> !TILLING Divm - <br /> EH 23 074 (Rev 3/22/91) • <br />