HomeMy WebLinkAboutNOV 2015Owner /Operator:.- '"0� -ire : -
Facilit : 5
Address: 414 A4a3lo L.
0
rued during this inspection
There were NO violations observed
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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 -:.
Signature:_ -
Received by:
Phone: `
Print Name:
Date: _ -
Date:.."
r - PRTIPICAT' ®N OF RETURN TO COMPLIANCE
1 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
_ V-11—. _ Pi ieineec rnn".tn ha ,-Pnt in after Return- to- Comniiance Pink Prevention Services Copy