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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # l �2 <br /> COMPUTER/PERMIT # �'3 � �0 0 <br /> SITUS/FACILIT�YIAD�DREESS: &g"/g <br /> t/ ro � L T 10 low <br /> DBA: /h7I 1-r hD(iF— r , RPi /TtIaY`A VV �1 <br /> BILLTO: NK F'P-oatt a*iG-,Ajti pp l�j of NozlN®''pHONE:96-0,56'517s7 <br /> BILLING ADDRESS: 9P.5-0 F17c�i <br /> CITY/STr\TE: 5A6oeAI4&"7'0 ZIP: 6?5—g27 <br /> PROGRAM: l Lfr TYPE OF SERVICE: ?e,~V'A-l/ d PLA J fL 4 ° J <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. 1 ,4-1- <br /> ,4-S do / <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> uF SAbI- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> TOTALS <br /> BALkNCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />