Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # �- <br /> (ops <br /> COMPUTER/PERI IT # <br /> SITUS/FACILITY ADDRESS: /ZS <br /> �' GoD2 G•� <br /> DSA: ��/� � �=,ec ��iv/E <br /> PHONE: <br /> BILL TO: S��G <br /> BILLING ADDRESS: <br /> CITY/STATE: <br /> �G ZIP: <br /> PROGRAM: Ti <br /> 3. 52TYPE OF SERVICE: 2F o �A� Evrk/ <br /> TFrE M TUa FOR EACII INSPECTION iS ONE (1) HOUR. ANY ADDITIONAL INSPECTION MME 1S COla[PIED TO THE <br /> NEAREST HALF (1/2) HOUR. INCLUDING TRAVEL'I a- <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REAS NAME <br /> SAM- 430PM-gAM/ <br /> I430PM WEEKENDS <br /> 9 � ZT/9�i •'00-8:30 ..� <br /> / �rI✓nJY_ GJ4(� <br /> broomeln- 27 <br /> SES r.c'rS G�AIu � Jr� <br /> � TAr1X--ippe�ar.J ,Q.EesK'Q �2Ei1 <br /> GJ � Z:3m- 3:vo Ar ETtA�G �,2rL <br /> 3; <br /> TOTALS <br /> BAI -v4CE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />