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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT #:;ru.-- <br /> CONIPUTER/PERMIT # f Cr/2 <br /> SITUS/FACILITY ADDRESS: �2 <br /> DBA: A d"A '`oI Jker=7u/s O�✓e� .S2'iS <br /> BILL TO: ,.t c ��v� SPv✓iLP �� Liavi Eras Co • b1c. PHONE: y�y 8333 <br /> BILLING ADDRESS: Rp Al L ro ice. S c� ^ , ?S> o <br /> CITYiSTATE: �oezip. 95ao� <br /> PROGRAM: 1165-1- TYPE OF SERVICE: T., A, A?4t9Pf1B y- <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 RENS NAME <br /> of SAM- 4:30PIvf-SA2vl/ <br /> SERVICE 4:30P:YI WEEKENDS <br /> w� I n 4%, rc - 3�v�b X t = 15 k L4 . eLk <br /> S own- H <br /> Z ro �f <br /> i :ao_ !LL <br /> YeSu-P �"'�NCcJ, Iw A /J <br /> W, /f-1, a3o -143,oZ <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br /> v <br />