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ENVIRONMENTAL HEALTH DIVISION <br /> UNIT # - ACCOUNTING WORKSHEET <br /> �! <br /> COMPU'T'ERfPERrr� <br /> SITUS/FACILITY ADDRESS: <br /> Q <br /> DBA: PHONE: <br /> BILL TO: <br /> BILLING ADDRESS: ZIP: <br /> CITY/STATE: <br /> TYPE OF SERVICE: <br /> PROGRAM: Is coMP� T� THETIME FOR EACH INSpECT10N IS ONE {1) HOUR, ANY PsDDIT[ONP�L INSPECTION ME <br /> THE i M INjyi !CLUDING TRAVEL TUVE <br /> T HALF 1/2) / 6`{���'r — J —�3 <br /> WEEKDAY WEEKNIGHT <br /> HOLIDAYS DESCRIP'T'ION OF WORK REHS NAME <br /> $ 4:30PM-8AM/ <br /> 4.30PM WEEKENDS <br /> f Too 5;30 4 k-h s <br /> + l,�R <br /> o W <br /> ,12•�2j rum c(oa� �w .� <br /> TOTALS <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/22/91) <br />