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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # G <br /> COMPUTER/PERMIT # <br /> SITUS/FACI ITY ADDRESS: (: ', I�o r <br /> DBA: PYnmjCu.uv dl w, �� �I;ODG?l (TLY� <br /> BILL TO: S/ PHONE: <br /> BILLING ADDRESS: <br /> j: 0 <br /> CITY/STATE: -/ ZIP: <br /> PROGRAM: °� 3' TYPE OF SERVICE: `1�u�,�C�. � <br /> THE i�JIIvIUM TI?,IE FOR EACH INSPECTION IS ONE (1) HOUR. ANY ADDITIONAL INSPECTION TITAE IS COMPUIED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL MAE. <br /> WEEKDAY WEEKNIGHT HOLIDAYS DESCRI''nON OF WORK REHS NAME <br /> 8AM- 4:30PM-8AM/ <br /> t{ 430PM WEEKENDS <br /> -A . 00' <br /> QS3o— l0:3 ;�EUifw - [�i ilc+cGLI <br /> �- <br /> � _ X; I� <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE <br /> EH 23 074 (Rev 3/22/91) <br />