HomeMy WebLinkAboutNOT. COMPLY MINOR 5/20/2015Owner /Operator.: - ooslj 6- C/v /
Facility: "i fAj d 'r r' D
Address: '` 1 -?UC e
REQUIREMENT FOR CORRECTION OF
There were NO violations observed during this inspection
Date:
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CORRECTION
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.
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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
re- inspection may .occur to determine compliance status.
SUMMARY OF VIOLATIONS
Item
Inspectors
Signature:
REQUIREMENT FOR CORRECTION OF DATE FOR
Date:
VIOLATION VIOLATION CORRECTION
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rc T'GSr-re-rtnN nF RFT' IRN TO COMPLIANCE
I certify that the violations noted above on this 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:
FT,tle:
Print Name:
Date:
KPS #8446
4 /1_a_' ....:...... .,.,. vaur%XA, _ RiiqinP:c-q crnnv to be sent in after Return -to- Compliance Pink— Prevention Services Copy
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Received b , t : :_
rInspectors
Signature:
Phone:. - 3-.706 Print Name:
Date: Date:
rc T'GSr-re-rtnN nF RFT' IRN TO COMPLIANCE
I certify that the violations noted above on this 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:
FT,tle:
Print Name:
Date:
KPS #8446
4 /1_a_' ....:...... .,.,. vaur%XA, _ RiiqinP:c-q crnnv to be sent in after Return -to- Compliance Pink— Prevention Services Copy