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0 or <br /> y <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COi'YfPUTER/PERMIT # I :j D ZZ -'5 W-, I:Zg Z- <br /> SITUS/FACILITY ADDRESS; (�_�_ <br /> DBA: 'r-�, c- 5f � 1 - <br /> BILL TO: J i1l;- D PHONE 92368 -61 yam <br /> BILLING ADDRESS: <br /> CITY/STATE: LC��(. C f1 - ZIP: —9672L-e935-7 <br /> FROGRA�M: �:� -TYPE OF SERVICE: ✓L� <br /> THE MINIMUM TIME FOR.EACH"INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> NEAREST HALF (1/2) HOF, INCLUDING TRAVEL <br /> 3 h,r IA <br /> DATE XF3I' HOLIDAYS DESCRIPTION OF WORK REHS NANIE <br /> of 8Alyf- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> - rye vZTo o <br /> `G /,I <br /> ql ,4-t o P1u�2 C 'tea o G�„fir <br /> �m Uel <br /> evr� <br /> f i--Ji ,Q� g-��}i l? !a S <br /> 8/0- cl) 1'00 <br /> TOTALS <br /> BAI-AiNCE DUE: <br /> BILLING DATE; <br /> EH 23 074 (Rev 3/91) <br /> A <br /> i i <br />