HomeMy WebLinkAboutMinor Violations 9-28-16peral -77 ;f c.�
owner/0' or::
Facility: P-1
Address.,.: < ,(78,LIN
There:wee:IVOvi''latioon:s-:observed during i. g this inspection.,,*
in the following..
Notice. it) t6i�� olation'-swere found u -this Jhspection as noted.
Minar-M d,d 'ring
M of 0
-Sum W lationsd
pry ''d vvithin'.30. day' unless
fi io must be,'correibte S9
The. violatidnt'.1indicated' in, this inspection report
otherw noted.
oted.
Formal enforcement maybe 'b 1-nitiated.f6r. anyviolatio'ns noted. and for those, not corr6cied. in -a.
.,
t there re'' other violations at this faoilit A
timely. manner... This report does not roprps�ent tha are no 0 Y.
re.- inspection may occur to determine compliance status..
SUMMARY OFMOLATIONS
CERTIFICATION. OF KF-TUKN FU UIUMMIANt-or-
Umma 'Icertify that the' violations noted. above-on this Notim to. :C.Omplyjs.+ ry.of:Vio.lations ha've� been
corrected !.`-[:h8ve. persbnalIV examined an documentation attached to the certificationAo'establi.sh that;
the. violations have been - corrected: ,
Signature,:
Title:
Print-Name:
Date:.
R *PA46
%Alk;4— : Dt;Inoeo rnnu Ypllnw — Business Coov to' be sent in after Return-to-Compliance Pink:— Prevention Services: copy
Item
CTi. .0
REQUIREMENT FOR CORRE ON F
DAT E FOR
VIOLATION
VIOLATION
CORRECTION,
ar
# 7k C�
A4,
ebto'
inspectors
p
Received. by
e,
sig.natuh
Phone:.
Print Na* M.e:
Date:!
N D
Date: ,
CERTIFICATION. OF KF-TUKN FU UIUMMIANt-or-
Umma 'Icertify that the' violations noted. above-on this Notim to. :C.Omplyjs.+ ry.of:Vio.lations ha've� been
corrected !.`-[:h8ve. persbnalIV examined an documentation attached to the certificationAo'establi.sh that;
the. violations have been - corrected: ,
Signature,:
Title:
Print-Name:
Date:.
R *PA46
%Alk;4— : Dt;Inoeo rnnu Ypllnw — Business Coov to' be sent in after Return-to-Compliance Pink:— Prevention Services: copy