Laserfiche WebLink
` ' r SAIL JOAQUII JITY PNBLIC HEALTM SERVICES/EWVIROWXUTAi; ,iLTH DIVISION <br /> T SITE WASTE THFI WASTE ASSESS �WIRCW ASSESSiHER PILOT PROGRAM <br /> `SERVICES YELLING RECORD PORN _517E SPECIFIC INVOICE <br /> 1VEEPS P <br /> IROGSu/ BELEMEHT CODE Z zi L/C -17E CODE 711OLEIM Y / M <br /> OC COOS IISTRICT �SSIGNED TO XURCE Of FUNDS STATE / FEDERAL <br /> SITE INFORMAYIOU SUBSTANCE <br /> !TE <br /> NAME �G 1`p �� r,f Y• TE FIRST REPORTED DATE ENTER PILOT <br /> ITT ZIP 2 L: �,w ICE 9 ACE _ OF <br /> BILLIMG/RESPOMSIBLE PARTY IMFORNATI&I <br /> E <br /> ILIMG ADDRESS PHONE <br /> ITT <br /> STATE ZIP <br /> TACT 1iA]IE PHONE <br /> rPE Of SUBMITTAL or <br /> ESCRIPTICN OF SERVICE <br /> DATE RECEIVED / / DATE OF SUBMITTAL / / T REQUESTED AYE Of REOLIESUD <br /> SULT CK P/ NW58 CIC S/ EMPLOYEE NAME• NCTIVITY HOURS WORKED MILES IOTAL LABOR <br /> DATE OTHER CASH PERMIT CASH CODE COSTS <br /> EES PO FEE PD " ST Of WIN <br /> 5 <br /> /7sd <br /> �s-..o a <br /> Pe S�fP f--C <br /> CREDIT 9 TOTAL ST HRS x t •D O IHR / Ua <br /> CREDIT OTHER PAGES TOTAL Of HAS x f /HR <br /> OTAL CHARGES THIS SITE �jS TOTAL W/H HRS x S /HR <br /> ATE OF /ILLING rjDTAL CREDITS TOTAL CHARGES THIS PAGE 6 <br /> BMITYED ST LJWCE DUE 3,.50 TOTAL CHARGES OTHER PAGES Xq.50 <br /> FH 23 Oji (5/89) TOTAL NILE TOTAL.CHARCES MS SITE S331•50 <br /> 89.006(IV)4/89 YILFRE! <br />