HomeMy WebLinkAboutCLASS II NOV 4-2017Owner /O erator:, rC,
Facility:
Violations were found during this inspection as
Address: z . " c ,
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Notice 4f Violation Cgjq�!jondlbr Class l
noted 'in the following Summary of Violation
Violations were found during this inspection as
The violations indicated in this inspection
otherwise noted'. .
eport'must be corrected. within .3O days; unless
'Formal enforcerhentwill be initiated for all Class
corrected within the required timeframe. This
violations at thisfacility. A re- inspection may
l Violations,`and for any Class ll -violations not -
eport does :not'represent that there are no other
ccur to determine compliance. status'.
SUMMARY O
: VIOLATIONS
Item
VIOLATION
REQUIREMENT
FOR CORRECTION;
OF VIOLATION
DATE FOR
CORRECTION
f
.
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Inspectors
S ig natu re: -
Received
by:
Phone a a c, , ; ;
Pri
t Name: a `\ i
Date: ` - - t -
Dat
KPS #6447.
White — Business Copy Yellow — Business Copy to'be
sent in after Return -to- Compliance Pink — Prevention Services Copy.