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%w � <br />ENVIRONMENTAL HEALTH DIVISION <br />ACCOUNTING WORKSHEET <br />UNIT # _.LLL <br />COMPUTERMERMIT G 3� <br />SI TUS/FACILITY ADDRESS: <br />DBA: <br />BILL <br />BILLING ADDRESS: PD• 6,2x i SD <br />CITYISTATE: /l 11cAe-c3 ZIP: ';';5 2! z15 <br />PROGRAM: U TYPE- OF SERVICE: IJ G T VSewc)yc-I <br />THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR ANY ADDITIONAL INSPECTION TME IS CONIPUTED TO TI -E <br />NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br />nal <br />DATE <br />of <br />SERVICE <br />WEEKDAY <br />3A.VI- <br />4:30PM <br />WEEKNIGHT <br />4:30PM-3A&f/ <br />WEE'.�c.NDS <br />HOLIDAYS <br />DESCRIPTION OF WORK <br />REHS N.OuMlz <br />I�-2`i-�� <br />o:io•Il,a <br />5 <br />.: �c �c }-l-tr <br />�.� <br />�) <br />I <br />I <br />I <br />i <br />TOTALS <br />4.sy:" s =�51• <br />BAL\NCB DUE: � .35 I <br />!BILLING DATE: <br />EH 23 074 (Rev 3/22/91) <br />r <br />/lr <br />•; <br />