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• � <br /> • <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT# e • -1' <br /> SITUS/FACILITY ADDRESS: ,s -J�oG� <br /> r <br /> DBA: 1a. cf) <br /> BILL TO: PHONE: <br /> � .. � m <br /> BILLING ADDRESS: .� �. _...A __ <br /> CITY/STATE: FIVS V,6 ZIP: 7 0 <br /> PROGRAM: �_ TYPE OF SERVICE: C -t- <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDRIONAL 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-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> 3 4;00-- 14)*.oo <br /> r.nn - 3.00 �•r,,,.>� <br /> c" <br /> hnl. Ar <br /> 3.00-L f,ecel " o o <br /> I►+r. < <br /> pow l <br /> C ,.rsn1 <br /> 1 i ! too— <br /> ` J r <br /> vi Ae�u <br /> TOTALS <br /> BAL1NCE DUE: I <br /> BILLING DA'L'E: <br /> EH 23 074 (Rev 3/22/91) <br /> .ire c� <br /> X3 , 5 c.�o i <br />