HomeMy WebLinkAboutNOV 2014Owner /Operator: VA L ` re,
Facility:,,;: a
Address:
0 There were NO violations observed during this inspection..
DATE FOR
CORRECTION
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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
re- inspection may occur to determine compliance status.
SUMMARY OF VIOLATIONS
Inspectors'
SigSi nature:.,.. ;d ;d Received by:
Item VIOLATION REQUIREMENT FOR CORRECTION OF
VIOLATION
DATE FOR
CORRECTION
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Inspectors'
SigSi nature:.,.. ;d ;d Received by:
Phone: .; d.;i =; - ' Print Name:
Date: / >, >- Date:'.
CERTIFICATION OF RETURN 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:
Title:
Print Name:
Date:
KPS #8446
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