|7300 S. Olympia Avenue W|
|8:00 am to 11:00 pm|
|Names of owners/proprietors here|
|Date, i.e. YYYY-MM-DD|
|Type of payment|
|stairs, bathrooms, handrails, aisle width?|
Then, put whatever you want down here! Note that http://local.google.com is sometimes a good and easy place to find times/phone. Better yet, look them up in the phone book, and ask them. Remove the fields you don't fill out — or even better, look up or call them for the missing information!