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30 <br />LOCAL HEALTH DEPARTMENT BUDGET <br />N.C. Department of Environment, <br />Health, and Natural Resources Revision Number — <br />Division of General Services <br />Div Division of Adult Hadth ----j <br />P. O. Number <br />07 / 92 06 / 93 3 5 5 0 3 0 6 <br />Effective Date Termination Date Contract Number <br />Contractor: nA t- <br />Project Director: _ g J 01 .$a t mo r <br />ITEM DESCRIPTION CLASSIFICATION ITEM AMOUNT <br />E STATE EXPENDITURES: <br />X Salaries & Fringe Benefits <br />Operating Expenses <br />p Purchase of Equipment <br />E General Contracted or <br />N Purchased Services GENERAL <br />School Health F <br />Activity: Health Promotion <br />Toad Budget: S <br />D Clinician <br />Laboratory <br />T Pharmacy Services <br />V <br />U <br />Transfer TX1X <br />R Subtotal State EMMd. <br />E LOCAL EXPENDITURES: LOCAL EXP 9a <br />S TOTAL EXPENDITURES — equal to Total Receipts <br />LOCAL FUNDS: <br />R Appropriation <br />E TXIX /SSBG Fees <br />Other Receipts <br />C <br />E Subtotal Local Funds <br />STATE/FEDERAL /SPECIAL FUNDS: <br />Y <br />P <br />T <br />S <br />Subtotal Snte/Federal /Staecia <br />TOTAL RECEIPTS — <br />101 <br />to Total Expenditures S <br />Local Authorued Official Signature Date <br />bow <br />Division /Section Signature Date <br />Finance Officer Signature Date Fiscal Management Signature Date <br />rr.rl <br />DEEM 2"S (Rwbmd 2192) <br />C,eeerd Services Dlvw6ou (Review 2/") <br />