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ID: <br />ENVIRONMENTAL HEALTH DIVISION <br />3 2 `�� ACCOUNTING WORKSHEET <br />r� 1 <br />COMPUTER/PERMIT # // q6 <br />SITUS/FACILITY ADDRESS: 4-I-�e,g S�U � / C� <br />i� �W� <br />DBA: {FtA L4�iCr-n/ K <br />BILLTO: 16- PHONE: -1300 <br />BILLING ADDRESS: L 3:ol S lE7Z= <br />CITY/STATE: l-e,<e hp Rff7% ZIP: 9 Zd v�o <br />PROGRAM: S2- TYPE OF SE VICE:-P�i�l� �- 7 /li/4�--- <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 <br />of <br />SERVICE <br />WEEKDAY <br />8AM- <br />430PM <br />WEEKNIGHT <br />4:30PM-8AM/ <br />WEEKENDS <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS NAME <br />It -("5 <br />30�4 <br />// ,^ �,11 <br />LAN <br />TOTALS <br />BALANCE DUE: <br />BILLING DATE: <br />EH 23 074 (Rev 3/91) <br />