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ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT# <br /> SITUS/FACILITY ADDRESS: ze <br /> DBA: <br /> oor <br /> BILL TO: �. / \ , �� '�� //YI�iL� �y PHONE: ogbgh*oa al ja <br /> BILLING ADDRESS: / . �i0,/, . �(.J:Qr /7a 6 <br /> CITY/STATE: StC- ! l ' eY , l /q � n ZIP: San 1 <br /> PROGRAM: Gf �,S 1 TYPE OF SERVICE: e-&c5'GCh.2 A �i/��QiL�jQ'J *- <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTMN TIME COMPUTED TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> �� ,a il:ooe,N,-lam <br /> C� S <br /> 2 1 I /% 30-3:3D v Ty/Il/'CJcGVwUvc��� C <br /> 14 <br /> TOTALS <br /> BALANCE DUG: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />