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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # /// <br /> COMPUTER/PERMIT# S (� j�j�f Ol `/A7� /J ' <br /> SITUS/FACIIITY ADDRESS: ESrt/¢ l,Ll/�+� ! - r_l o-=w- n <br /> DBA: I I r h°Q-LO�B�, J�G�J. TTII <br /> ,r <br /> BILL TO: ,t42/- PHONE: <br /> BILLING ADDRESS: A-E/ �6 F✓`! <br /> CITY/STATE: rr��rl 1p 'r— , !Y ZIP: <br /> PROGRAM: O) ?t 86 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 /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIMON OF WORK REHS NAME <br /> 8AM- 4:30PM-8AM/ <br /> 4:30PM WEEKENDS <br /> /I-4-c1 <br /> ii al-q 1:30 <br /> 3- ,45 <br /> 31-`t5 9;30 — o Rev;e", s � <br /> TOTALS <br /> BALANCE DUE <br /> /�R SOS�f Q D <br /> BILLING DATE <br /> EH 23 074 (Rev 3/22/91) <br /> 2- p <br />