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HomeMy WebLinkAboutUPI CHECKLIST (2)Owner /Operator: 1 ` "a-. /, 7 Facil.i : J, SC#cj<c b fS -,- -r F -p- Address: 0 / There :were NO violations observed during this inspection. Y.' r. 3. n e <... <A':w? Y: "w•'.. k'. ,:.- .RF'n,vz.., 2}.x N3 k :. >.. ,.,, 3i. s. s ..... t... ,. _.. :... ... „". a4 3SL M.. u" . 1 ., S.. .... i .. 1 .. a, ....... . e .:. x .. x.?.. ... ... "..:: T, W.....o,..... 011v .....",?v.. .. ' . . •,Y8e.. x} <5 .n '. - .e , v ., ...., .. A. ,. ... ...:. ds. .., ... ,. ,::,:. € n4....:..vs• Cx... ..r} u. .v.., S” ..:. t. ._. f,. '... .k u. ,. ! Y 'us...s.,..x2 ::'.,. 1 s s ?k; ...a.. _ e' 3.,t aiT,vn ,.. -,v, , r.' ,.. ., h K',.>:•e.. . r... _ .: .,.. rt. `'Y` _. ..,' ... ,. .'v: .xi >. Notice to Comply.- Minor Violations were found during this inspection. as noted in the followingg P °,- c. ' - _ ` ^ate J -Z "Z X 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 Received by: Item VIOLATION REQUIREMENT FOR CORRECTION OF VIOLATION DATE FOR CORRECTION. ate. D ate: _. P °,- c. ' - _ ` ^ate J -Z "Z X r r .. f I nspectors r; `. _. Received by: Si nature r.., g Phone: _ ,, -: -. r_..._.. r'' ..y 9 S Print Name: a+ ate. D ate: _. r_FRT'F'r_ATI()N nF RETURN TO COMPLIANCE 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 1Arh i4.,. Q.oincc + r,,,,., vAu r _ Rr.icinaSS Cnnv to be sent in after Return- to- Comaliance Pink Prevention Services Copy