HomeMy WebLinkAboutMINOR VIOLATIONS 11-26-2013Owner /Operator:
of Viol
.to the certifi6atson
tions have been
to establish that.
Facility:
Address: d`- = x Cam-
Print Name:
There. were NO violations'observed during this inspection.
•
.., e+ ;z2.'
!,.''E .: �,:
., c.. e. , -r,
x..s:x::, z ..ra .:., ✓....r . a.�.: ..' .. : " +s.Mx ,v:si: ,. n... M 'w :, xc ,. ...... ;,L
e .P .. „> 'r. '.v .x?. . .._.i n.. ..:.. ... ..�..fls, 5,. ..�i' ... 5 .Xs.✓H"FV .. i..x... , v-... . ..... � F� i..
_._... �c5„„_,, .. E.: ,. _. L, .:..> »...,3, „#.rh.• .'i.,,.. ..w'x','vn,'v. .,� L. .._ _4�".., tC.- ., ,._. ». &..
..... ✓ -... s.. , .�.` � . #... ,. ,_. ._ .... ,+ "...;: , .. � »_ „r ....rr. ✓ � :.. .........: :�i,, - k ` xD
_
k. E ';d S r� :k,:
.. 3:'; ::.: ». g
.9b .. t
,ELY `
T� ... +Fh v >'+"y
..y ' Cx�a -•; .��,3?�'
"�..t �....
y.
� �h
.. , ..
. < ee 3, , . ..
..n ...�. ... , ... u. . 3. .. .. .�4 .,..';4_ -, .:i� .. �� 'X. 3�.:: < :, T' ...
r ..a . Y.' < ..,b, ..:'.SY .,. .. . r,. tea.✓ L. h ,ee., 3 1e s "^i+ .. ».. „ -.-+a. . »3,1 E, 4 .., o
x � ✓
4f s. .! 3,”
�A : _ a��'� xro,�L..
g • StYZ•.
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 viol,
Itions at this facility. A
re- inspection may occur to determine compliance status.
SUMMARY OF VIOLATIONS
Item VIOLATION REQUIREMENT FOR CORRECTION OF DATE FOR
# VIOLATION CORRECTION
R c`.
p�.
1 ; aF^ d
2 : .4�' s1� r+ -/' = `d'' .�Y .� �! . ( '7 f �16Jx a R. {e �' a,,°` '"*e f ' F (', � %%4A /"/1-3
i
:Inspectors
Received by:..
Signature:,
Phone: . TPrint Namee"r .
Dater Dater, ,
CERTIFICATION OF RETURN TO COMPLIANCE
certify that the violations noted above on this Notice to Comply / Summary
corrected. I have personally examined any ,documentation attached
the violations have been corrected.
of Viol
.to the certifi6atson
tions have been
to establish that.
Signature:
Title:
Print Name:
•
Date:
KPS #8446
White — Ri icinacs r.rim
YP_IInW — RI1SinA72S Cnnv fn hP SP_tlt in ;a tPC RP_tnlrn tn- Cmmniign( P_ Pink — PrAVP_ntinn SP_n'VICPS Cnnv