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I <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT#-- <br /> COMPUTER/PERMIT # ilY/ <br /> SITUS/FACILITY ADDRESS: _ l /D /_ ,lam ar e <br /> DBA: SCir ✓oaycr�d, Co , l �z�'��.-, �fi�c7 <br /> BILL TO: SbcZ 1Dr7 SPS JrcP u �u-� ��')i/fo Flo.-es PHONE: '-/6 V <br /> BILLING ADDRESS: 3>a-o A-), Gl., <br /> CITY/STATE: ZIP: Al T <br /> `lSaya- <br /> PROGRAM: �, TYPE OF SERVICE: ,Di '�tG y��Uvu% cf {'P/�l� ~Apg <br /> THE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL INSPECTION TIIvm 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 SAM- 4:30PM-SAM/ <br /> SERVICE 430PM WEEKENDS <br /> rsza <br /> �iai�-/o z N A <br /> & /" Z- <br /> /,7 2- <br /> U s r ��, ` ✓ •mss ,�� t11 A' <br /> N-1^ <br /> 91,9 v �o-i�.gym , su..� 4.. r,s k N V <br /> IFTOT <br /> i <br /> BAI..ANCE DUE: I95. 50 <br /> BILLING DATE <br /> EH 23 074 (Rev 3/91) <br /> i <br /> i <br />