HomeMy WebLinkAboutclass 1 violationsOwner/Operator:.. Pc ,k �" �°- � �, � �� A.,7
Facilit . . .: Z� 7-7 :
Address: - (n, F ,- ( r,
Al IMMARY ()F VIOLATIONS
Inspectors'
Si nature: .� , ___,.�...
Notice Of Violation: Class H and /or,Class olations 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.•
Dater i - c--
Formal enforcement will be initiated for all Class I Violations, and for any Class 11 violations not
corrected within the required timeframe: This report does not represent. that. there are no other
violations at this facility: A re- inspection may occur to determine compliance status:
Al IMMARY ()F VIOLATIONS
Inspectors'
Si nature: .� , ___,.�...
Received by:
.
Print Name: _ °fin L) "I /A C. r :
Dater i - c--
Date :. 19/ 1 (
KPS #8447
White _Business Copy Yellow — Business Copy to be sent in after Return - to- Compliance Pink — Prevention Services Copy
CLASS 11 AND GLASS I VIOLATIONS
owner/Operator:
Facility:: 4 ; IZ- E 0 0. . 1 g
Address::
n
Notice Of Violation: Class H and/o lass l Vio/afions,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.
DATE .FOR
Formal enforcement will be initiated for..'all. ,Class: 1' Violations, and for any Class li violations, not
corrected within the required timeframe. , This report does not represent that there are no other
VIOLATION
violations at this facility. -A re- inspection may occur to determine compliance status..'
SLJM.MA'RY OF VIOLATIONS
It em
REQUIREMENT FOR CORRECTION
DATE .FOR
#
VIOLATION
OF VIOLATION
CORRECTION.
�ia�S'Y
YJ«RL
—�,r�
irk+3 8...�f
'
�
2 _"' ^' .� 0/�� `AP . Yw+.' ..✓' 8 Y "' «I' J .� ��1 /P 'M••. "! "'4/.
-
.
. L y {{. . }. §.(. y�.f..f .p�/g°' ,y. $ j�_1 y 7`�17.r
�f.'
'O� 5 �$ = "i � v 0� A � °y.... �Yd` :F Pl..+' °"'9 � fr �v..
�..
f+�..•
{q_ i'r �f p,,4'r�'p�` A' p�'�'•�. �j i^' �"�
R.' � ..w�- a° f
• .. �.y. .. f VU S..f
fi�ggif � .. 2_0
� ' .. a f 3✓ % � L 7 .
s�.
..
..J 4. $✓ '. "} Po
Y C° "P^;� -q� 'Sr .G: � f + . �C✓ •
rte«. a,` $,' v`�38 5 sr`� ret►
°..
ty, o U ( mid-•& .E..�" `#'�' 'R:. f ;"t✓
•
�'. °.'�- ��ee'" ..3r ff .`$'"_
-
''� �f d d• # k d^ 7 i=o C tc GJ6�k"'
... '"
' sue
�kc f✓�r ` 8✓r.��p.+�
[ \f
; y ;• T `"Y .. � �Y�.Y_.w� 3 PMd. i �R�� Yp'y�.n..y'`
�� ''
r�
Ene' tors
tur -e: °-- -- ~
Received- by:
f -
F'
Phone: M"
r ; 4 �^j s ..-'D tire`?"", ds'v` ,
Print: Name: -
Date:'.�
Date:
KPS #8447
White - Business Copy Yellow - Business Copy to be sent in after Return -to- Compliance Pink Prevention Services Copy