HomeMy WebLinkAboutMINOR VIOLATIONS 7-30-2013Owner /Operator:
Facility: 1 XP M
Address:
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Print Name: 12 1
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Notice to Comply: Minor Violations were found during this inspection as noted in the following
Summary of Violations.
The violations indicated. in this inspection report must be corrected within 30 days, unless
otherwise noted..
Formal enforcement may be initiated for any violations noted, and for those not corrected in. a
timely manner. This report.does not represent,that there are no other violations at this facility. A
a
re- inspection` may occur to determine compliance status.
Item
P
_
SUMMARY OF VIOLATIONS`.
` REQUIREMENT FOR CORRECTION OF DATE FOR
VIOLATION VIOLATION CORRECTION
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A � P C, 4.10
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S�el J�tl _1,14)( t P �L_ U040 j3aiL
Inspectors`
.Received by:
Signature.
Phone: !' '`
Print Name: 12 1
Date: -
Date: (_
rFQTSFrr®T1t7N IF RETURN TO COMPLIANCE
I certify that the violations noted above on his Notice to Comply /Summary of Violations have been
corrected. I have personally examined any documentation attached to the certification to establish that
the violations have been corrected.
Signature:
Title:
Print Name:
Date:
KPS #8446 .
1A /k;4- , 0-; r,^M11
vAu��A/ RucinPSm Cnnv to be sent in after Return- to- Comoliance Pink Prevention, Services Copy