Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # i�� <br /> COMPUTER/PERMIT # OW,624//0 ''// <br /> SITUS/FACILITY ADDRESS: /0`1 PO IOCV f e /Z t"9 Q r <br /> DBA: __ f�,--ry ��OG, ` 1,ly4gm!g <br /> BILLTO: `11,4( f=, EAd� 0-2L PHONE �2oy� 3�$-6175 <br /> BILLING ADDRESS: -go . 130X 3` z <br /> CITY/STATE: ZIP: <br /> PROGRAM: Z3- 5D TYPE OF SERVICE: rLoSvPE 81,461 9C <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 /> of SAIVI- 4:30PM-3AM/ <br /> SERVICE 4a0PM WEEKENDS <br /> // ZS 9 Ff;pv-9:'JVp G��vPE �l�/QEviF,CtJ �ieE1/ <br /> IZ � a1 �.va,�;hjD� R.Fjcovi4L R.EPcte'r L- `ENI�- <br /> z �j7 A iv.un �o: h CGvha����6Pak *5 FAiE� <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />