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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # 3 <br /> COMPUTER/PE-RMIT # C,4RDW y!7 ,SGdUlad 4d---�f�� <br /> SITUS/FACILITYADDRESS: 7555 Ai PfrS4t !zf <br /> DBA: � �/��e-Ild✓I rd laid J /D <br /> BILL TO: k lT /YJowg=2 D P /OHNE: <br /> BILLING ADDRESS: <br /> CITY/STATE: 7 ZIP' <br /> PROGRAM: TYPE OF SERVICE: <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> E=1/2) UR, IN LUDING TRAVEL <br /> • D hr-5 an // !y 9/ <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> uI SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> Ihr PAID ir. rw CvW Ge <br /> D 6 /e remcv <br /> Le <br /> lD 30 — Wrrafe uP <br /> �BlQ2 I ► PA-1 s <br /> TOTALS <br /> BALt.NCE DUG: <br /> IIILLING DA'Z'E: <br /> EH 23 074 (Rev 3/22/91) <br />