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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # � L I <br /> COMPUTER/PERMIT # rAASCOI <br /> SITUS/FACILITY ADDRESS: ��7 yn/Zladb2Yq 651� SAe/7 <br /> DBA: C-2��/zt I > vlQfl bri nC!//7/r7/ 7161�6Y1- �IIY 7r { ro-n-4r6 <br /> BILL TO: ARlArl-A PHONE: 1/3- Z9% - <br /> AV,v� <br /> w'/Jiarr, cope/w t- <br /> BILLING ADDRESS: fA� rac,-W;; s -41yP - y6V S / S000 AV�aT/oN 8/tb, <br /> CITY/STATE: 05- <br /> h1awAWWe! CA ZIP: 9020 6 <br /> PROGRAM: I/� [�TYPE OF SERVICE: /IP nova <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 /> uF SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> f} 511-?191 <br /> 5 g 9/ U:30 m I relimmayy veuLeaJ (//elC <br /> 5 10:00- — PPkD l r hone ca l S mWf s �M� / <br /> 31/ 11 12:OD LL ,GY2 Ihr d raFt i F6F Tl Ctv wwnn wail �6& _N�l <br /> /y X0:0 Ob 1 eviea� res�gm�rFnQs <br /> Cl ra(-F I-N y <br /> i s <br /> TOTALS I L�• S <br /> BALINCE DUE: Z 3S .S6 <br /> BILLING DATE: —1216�9/ <br /> EH 23 074 (Rev 3/22/91) <br />