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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # K AI(1-T �� SWCZ�S 1sz�1 <br /> SITUS/FACILITY ADDRESS: 1 W �i�rl�T 1411-J -JDDIL) �gML6yj <br /> DBA: K I Air :QX 11b l Sine% <br /> BILL TO: (2ih7 ) /' )PR-A.)C PHONE: <br /> BILLING ADDRESS: TO Bnj� �29,gtS <br /> CITY/STATE: /�/ / lI C� 1 ZIP: _gig <br /> PROGRAM: I)I^� TYPE OF SERVICE: 0QA 5LY �an <br /> T, 0 c 1 _ <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 /> I <br /> 8AM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> 3 210 9 /0'sii s""' <br /> TOTALS Z <br /> BALANCE DUE: S Z u <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />