Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # .J= <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: <br /> DBA: — ('afP IIy5yd00/79Pi17� Q <br /> BILL TO: —.. 45Y �/ -, 6e5- - <br /> _ Yl c� j Z PDHONE <br /> 4/15 <br /> BILLING ADDRESS: _ 7'eln � <br /> CITY/STATE: O/val`nGo, ( 4 ZIP: <br /> PROGRAM: - V5T- TYPE OF SLRVIC / /y � <br /> - <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. I, <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME w�N� <br /> of SANE- 4:30P,M-SAM/ <br /> SERVICE 430PNI WEEKENDS <br /> qj <br /> �j <br /> L� r✓O �l ;C'Z) i Itir }-:" ic; �Qt.Ult'tJ iGSOi�m[f�C� . ;� <br /> Remwa <br /> gZq 9/ 9!0 <br /> %D_ /? Gd�� vPr2mlcy IQYl1 Idle <br /> /b v 91 11:2 oo ; h T : l' evvi y(2resof� dYY! <br /> I <br /> I <br /> gQjZl�'ZLLGt� <br /> TOTALS <br /> �l�ve- 611 <br /> BALkNCEDUE: II2 hrJ <br /> BILLING DATE: ✓ M/Ia n i n� <br /> EH 23 074 (Rev 3/22/91) <br />