Laserfiche WebLink
ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # <br /> COMPUTER/PERMIT # <br /> SITUS/FACILIT <br /> JY ADDRESS: -,� <br /> DBA: Sfac 11 SJ�' i'4� /9 �O�J G�7'G/1L�f��7'Al) <br /> BILL TO: Li/��.�TY� ��/AfJ�yZJ G q/17 Q yJ'' G. PHONE: (7a7) <br /> BILLING ADDRESS: �Q� Uhf O <br /> CITY/STATE: Vo-r a,' Lr( e (f 109-0 4 ZIP:,?5 r <br /> PROGRAM: G( S TYPE OF SERVICE: <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. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of 8AM- 4:30PM-SAM/ <br /> SERVICE 4:30PM WEEKENDS <br /> TOTALS <br /> BALANCE DUE: y S <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />