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ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT # <br />COMPUTER/PERMIT # <br />SITUS/FACILITY ADD ESS: 4()4'g Wa-kertot, <br />DBA: Mao tDUJC Propc <br />BILL TO: Nark) vv e n.ct_ <br />BILLING ADDRESS: 4" BOA 15O- 21 I <br />CITY/STATE: S0.17-1 Ct{s q e <br /> <br />(415) <br />PHONE: 45 -2351 <br /> <br />ZIP: CI LI (1LS <br /> <br />PROGRAM: a3 TYP OF SERVICE: <br /> <br />Lai° Awaysis <br /> <br />THE MINIMUM TIME FOR EACH INSPECTION IS NE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br />NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL ME. <br />DATE <br />of <br />WEE-I= WEEKN4G-14-T DESCRIPTION OF WORK REHS N.,kNIE LIDAYS <br />_I-WE-EH:ENDS- SERVICE <br />8AM- <br />440P-M . <br />A VVIDL) (TT <br />q.ILI 13 4-7cis 14\143-01p 0 vc,c._ Am, kp cs (Way <br />raka <br />3 <br />a SOO 0,116vIc tcti/LA r----(0 t- Pcr\alkt s ( s <br />isklYquw P'Aci 3eLni- Wel. Su{ \J .. <br />TOTALS <br />BALANCE DUE: <br />BILLING DATE: <br />EH 23 074 (Rev 3/22/91) r0