Laserfiche WebLink
r y <br /> ENVIRONMENTAL, HEALTH DIVISION <br /> � r <br /> ACCOUNTING WORKSHEET <br /> UNIT 4 <br /> COLN[Ki I'ER/PERIMIT # ??15Z) <br /> SITUSlFACILITY ADDRESS: l c. i� <br /> DBA: Scrr/vim el--57 <br /> BILL TO: S�/�Cc� PHONE: <br /> BILLING ADDRESS: -- ,5,'--3 _ /�G l 6niK <br /> CITYISTATE: <br /> PROGrAtiI: /IF TYPE OF SERVICE: <br /> TI-M .M M1MUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDMONAL INSPECTION TIME IS COMPCIT"r.D TO i'HE <br /> NEAREE5T.HALF C1/2) HOUR, INCLUDING TRAVEL TME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK REHS NAME <br /> of SAM- 4:30PV-3ANI1 <br /> SERVICE 4:30P.lyI WEEKENDS <br /> A,n <br /> I ! <br /> TOTALS <br /> 13ALrrNCE DUE: / <br /> BILLING DATE: i <br /> I <br /> EH 23 074 (Rev 3/91) <br /> 5 <br />