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1 <br /> ENVIRONMENTAL HEALTH DIVISION <br /> ACCOUNTING WORKSHEET <br /> UNIT# _ ' <br /> � j-0 <br /> COMPUTER/PERMIT # <br /> SITUS/FACILITY ADDRESS: /J-/-/-) <br /> - <br /> c <br /> DBA: <br /> BILL TO: S&Z ,Gi>� SPS ./I P 5-1-6t cu-� /!�'J,�Cm �/u.-�?S PHONE: <br /> BILLING ADDRESS: f5' o ti. <br /> CITY/STATE: ZIP: <br /> • r.-caw.�s s�//�- � <br /> PROGRAM: //XJ 71 TYPE OF SERVICE: <br /> G�'r9S1'L <br /> TriE MINIMUM TIME FOR EACH INSPECTION IS ONE (1) HOUR, ANY ADDITIONAL.INSPECTION TZ E IS COMPM-1) TO THE <br /> NEAREST HALF (1/2) HOUR, INCLUDING TRAVEL TIME. <br /> DATE WEEKDAY WEEKNIGHT HOLIDAYS DESCRIPTION OF WORK RENS NAME <br /> of SAM- 4:30P.M-SA.WL <br /> SERVICE 4:30PNI WEEKENDS <br /> t5- r e v.F,,,> / r� <br /> n <br /> r <br /> 1 �Q <br /> -5-aLIN <br /> 79 , a w•+.2yslr kr��t 1 <br /> lti 7i /p"/l/�r�^ r �` ' p - �cc-co-P <br /> v <br /> i <br /> TOTALS 1 <br /> i <br /> BAIANCE DUE: <br /> i <br /> BILLING DATE: <br /> EH 23 074 (Rev 3/91) <br /> f <br /> i <br />