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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT# <br /> COMPUTER/PERMIT # <br /> / rI d X3813 <br /> SITUS/FACILI'I-Y ADDRESS: <br /> DBA: <br /> BILL TO: N S�yo /j nG 6-//4 A/ -7/✓C /PHONE: ' p <br /> BILLING ADDRESS: � 4A <br /> ly- <br /> CITY/STATE: s `7 r ZIP: <br /> PROGRAM: V S� TYPE OF SERVICE: T�N�� /Z�-A4✓ <br /> THE MIDUMUM 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 SAM- 4:30PM-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> S o <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />