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+ r : <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT# Z&" <br /> I vQ <br /> SITUS/FACILITY ADDRESS: /ZU� Z S /W • W S' <br /> DBA: �► V��CGCX l`�/�1oirl/YA �y <br /> BILL TO: �II��� /J � Ld �%i" �� S&1xad PHONE1: Z�fS—S32/ <br /> n <br /> BILLING ADDRESS: <br /> /V P'D • X S 8 <br /> CITY/STATE: I � (-D b� CLR ZIP: 0364 <br /> y <br /> PROGRAM: -,�)T TYPE OF SERVICE: IWmUI/xi <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HO ANY ADDITIONAL INSPECTION TIME IS COMPUTED TO THE <br /> N T (1/2) HO INCLUDING TRAVEL TIME. <br /> • ` ..— o -02- v kbEt pd Ll UC44/n�,c ave <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRIP'T'ION OF WORK REHS NAME <br /> 8AM-n `� 4:30PM WEEKENDS <br /> Or . <br /> witra,56eA rormova.t L <br /> I� b ! usT <br /> II'N 'gz, 02'.00 QC�� UJri+e pY�m.or- �rspart <br /> new A+- <br /> --z r-,-q-Z <br /> -2.5.82 2 " jo:yh LpiIL I� o� 5a:x <br /> 1753 , <br /> D-4z I`2 rry 2 gIW ;tedudctw °`" iI-2 <br /> q:oo, e .w <br /> IZ'llo `(2 10:oo tl,V tonin M. <br /> TOTALS <br /> BALANCE DUE: Z 3�• <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) /� <br />