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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> CONIPUTER/PERNUT # Q 5 'S <br /> SITUS/FACILITY ADDRESS: e <br /> DBA: PCD}e( � Lnrc pp l <br /> BILL TO: m or <br /> � D 1 1 c P4ONE �zos\ 368 -6175 <br /> BILLING ADDRESS: <br /> CITY/STATE: La ZIP: _9 zy/ - O3 S-7 <br /> PROGRAM: �23 F-c) TYPE- OF SERVICE: - E C/c7Sv r <br /> TFiE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS CO24PUTcD TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAN[- 430PM-SA.M/ <br /> SERVICE 430PI4 WEEKENDS <br /> H(l 9/ �6:CD4(0' <br /> C.Qo�cuc.e .4.P�u do J�- <br /> I I I <br /> I <br /> I <br /> TOTALS <br /> BAL\NCC DUE: <br /> BILLING DATE: <br /> Ee 23 074 (Rev 3/22/91) <br />