HomeMy WebLinkAboutUST-VIOL NOTICE 2/9/2015Owner /O. erator:. _ E-e-Pr f- _
Facilit - r -). A2�- bs .
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SUMMARY OF• VIOLATIONS
Inspectors
Notice Of Violation: Class Hand/or Class l'Vio/ations were found during this inspection as
noted, in the following Summary of Violations.
Signature:
The violations indicated in this .inspection report must be corrected within 30 days, unless
Phone:_
otherwise noted.
Date:
Formal enforcement will be initiated for all Class I Violations, and for any Class 11 violations not
corrected. within the required timeframe. 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
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Received by:
Signature:
Phone:_
Print Name: �;'
Date:
Date:
KPS #8447
White — Business Copy Yellow. Business Copy to be sent in after Return- to- Compfiance Pink — Prevention Services Copy
Owner /Operator: 41Z cz 5 '(cl. .
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.Address
There were NO violations observed during this -inspection.
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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 thin 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
rco-r1C1nATlnN1 nG RI=TI IRIAI Tn MMPI IANCE
I certifythat the violations noted above on this Notice to Comply/ summary. of Violations have been
corrected. l have personally. examine d any documentation, attached to the certification to establish that
the violations have been, corrected.
signature:
Title:
Print Name:
Date:
KPS #8446
IA1L:L �.._:....,.., �,.��, von.,,A, _ R„--,npQ-- rnnvtr) he sent in after Return -to- Compliance - Pink - Prevention Services Copy