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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> ERMIT # I D <br /> L�ry 3 0 <br /> COMPUTER <br /> SITUS/FACILITYADDRESS: <br /> IT- 3 d I Vy w 52�I Z <br /> DBA: J-� I e W I Mali- P. <br /> BILL TO: 1 ol 1 q5 VI C PHONE: 2 5 - 90G <br /> BILLING ADDRESS: I nn <br /> CITY/STATE: 3o-n An,,reQs n C ZIP: `I5Z <br /> PROGRAM: ��`� TYPE <br /> OF SERVICE: Remwao- <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 SAN[- 4:30Pb[-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> revleou awe P an <br /> IO'30— I iolka-1' <br /> s19 <br /> r;= � rI <br /> �31 ql t2 330 m v q ke'rnP G ,PBm wow /7Q/V✓I (�lo <br /> TOTALS <br /> BALINCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />