HomeMy WebLinkAboutMinor Violations 11-16-15Owner /Operator:t
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[] There were NO'violations observed during this inspection, :
® Notice to Compty.- Minor Vio/ations 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.
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: :
F Print Name:..
Date:
KPS #8446
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SUMMARY OF VIOLATIONS:
Item
REQUIREMENT FOR CORRECTION OF
DATE .FOR:
VIOLATION
VIOLATION
CORRECTIONK
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Received. by.
Signature :.
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Print Name: yl�- -.
Date:'
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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: :
F Print Name:..
Date:
KPS #8446
v_u_... v...:.... ,, r ,..... 4— k- c.on+ in nf+or Rc +i irn_ +n..['mmnlinni -P Pink — Prevention Services Co.Dv