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dl w <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT # \J <br /> COMPUTER/PERMIT # 5l 2 � <br /> SITUS/FACILITY ADDRESS: <br /> DBA: I SL�Al i0= <br /> BILL TO: WOSTZ-Y-= -" M -so-f: U ICE, I fir.. PHONEPI -L[Z`f <br /> BILLING ADDRESS: SlUi iE <br /> CITY/STATE: CA- ZIP: 95ZC <br /> PROGRAM: OC l TYPE OF SERVICE: �T <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-8AM/ <br /> SERVICE 4:30PM WEEKENDS <br /> WCT1Je%et i-oulbA-1 i5T <br /> 5 rC FLU OCT YR <br /> 3 W ITWE55e-D B�4u�+-a�l tvGr lr <br /> �PPttiYa- <br /> q —pH`11�> Ftz <br /> pi4MEMFTL'� 7-' lPtk)CT IiNS?- <br /> { '1 -ag PMI c7n, I E��t ara.Conlr�c7II�iv i <br /> 34D 30a PeRFo-N®-jj Z" -p,p a wc-r <br /> ,� -' <br /> rem 30 PM AV'FNP" RI NA-L tNSPL --r7blJ <br /> ( -- o-FES fYaT f U PICT-►o N I K)cT <br /> 3' t <br /> ?moo 5^ c <br /> , i t h�SP <br /> t- F <br /> 4 3-) ql �O l 3a 1 � <br /> TOTALS Ll <br /> BALANCE DUE: <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br />