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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # 0AM E AC <br /> j <br /> SITUS/FACILITY ADDRESS: 5,25 l,(/j.-f S ) KcA--r—(' of <br /> DBA: U14m E p-bN <br /> BILL TO: � i�s r-a PHONE: <br /> BILLING ADDRESS: <br /> CITY/STATE: 1.3 Co.- ZIP: 5 Z O 3 <br /> PROGRAM: )� 5-'00 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 /> SERVICE 4:30PM WEEKENDS <br /> nZi <br /> o- !;3 0 / �c �o ! X47s�raw �;� Ir <br /> �.� <br /> PIAVrf-IS k-kk,; , <br /> L �t <br /> p D //:oo -- ne W S -e <br /> 2 i'P 1 riSPP�-Pion <br /> q- -c1 �M Moon Z -twl <br /> y,00 <br /> 424 <br /> on <br /> TOTALS <br /> BALANCE DY1E: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />