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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # _.4;L <br /> COMPUTER/PERMIT # 77/ r}�3 <br /> SITUS/FACILITY'A/DDRESS: 7 7oJ %Q�,,� 0 <br /> DBA: li�i/y Gist <br /> BILL TO: — PHONE:6 7- 7x3 <br /> BILLING ADDRESS: 21109f{Y7; �R7` <br /> CITY/STATE: _ ZIP: <br /> PROGRAM: a 3. TYPE OF SERVICE: <br /> Gc G S <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 1VEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 3Abl- 4:30P�I-3AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> ' �shoe cp�j <br /> !30 <br /> -93 /0.00- /a: oq !t c2 Ti H�Tz <br /> -? /o'•� 1a :� Fin ! wI cw <br /> TOTALS <br /> BALANCE DUE: l <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />