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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> r/uNlrT# -3 I <br /> COMPUTER/PERMPP # iS/o <br /> SITUS/FACILITY ADDRESS: 4"9-0-7S.��oor_� Tc r <br /> DBA: C U 5 X(� <br /> BILL TO: PHONE: Y <br /> BILLING ADDRESS: �1 -7 /J,r <br /> CITY/STATE: ZIP: <br /> PROGRki'vI: TYPE OF SERVICE: - <br /> THE WNIMUM 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 j7DAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 4:30PM-SAW <br /> SERVICEWEEKEN <br /> cti.�.�...,..,,. .. w yrs s, <br /> L 4Z. /o =��/�:f cusjw cowZ <br /> ' � pa ?a I �iS'wSLd �7u-Cta W/arxy <br /> /fC y,+rcy4 re s!-vuFlr•7e /VT <br /> TOTALS <br /> RALUVCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />