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ENVIRONMENTAL HEALTH DIVISION <br /> • ACCOUNTING WORKSHEET <br /> UNIT # �- <br /> COMPUTER/PERMIT # �v�D/ 5 �` a3 V3 <br /> SITUS/FACILITY ADDRESS: <br /> DBA: J <br /> BILL TO: /1� Di 7 PHONE: Oorr)333-Q.23$ <br /> BILLING ADDRESS: D• _ � `� / Q <br /> CITY/STATE: � /4 <br /> C ZIP: Q5o? I <br /> PROGRAIM: of 3• RO TYPE OF SERVICE: <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 /> of SA VI- 430PM-SAM/ <br /> SERVICE 4:30PM WEEI�NBS / <br /> qaA -141-91 3 ' °-- CloSure lavL,qg 11 <br /> L. RpscA- <br /> �pjt� 5-17-91 <br /> 1) . . <br /> - ,� c,�, L• Res <br /> i le�c ,`aQ Res <br /> i <br /> i <br /> TOTALS <br /> BALANCE DUG: <br /> BILLING D,\'Cr: <br /> EH 23 073 (Rev 3/22/91) / <br /> J <br />