Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # — � <br /> SITUS/FACILITYADDRESS:�I 7 ��� �/��ST WPSfC /Y(fIZQI <br /> DBA: 4 R C D 6 W4 R . <br /> IM q JCq <br /> BILL TO: RD bar f-7� 1� W n PHONE: <br /> BILLING ADDRESS: I DD ,, ,w / <br /> CITY/STATE: LLsa/ �l;�/iL('�(A�G'�D, `/�T/1 ZIP: <br /> PROGRAM: � 3• �P � TYPE OF SERVICE: �/L/'STi[X.f� 9�i`DvcJ /^/tel ccJ <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDrMONAL 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 SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> 130 /'QC <br /> r <br /> I <br /> i <br /> TOTALS <br /> BALkNCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />