HomeMy WebLinkAbout-NOV CLASS II 4-2017(;LASS RAND CLASS 1 VIOLATIONS
Owner/.Operator:
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Address: 4 i = G
-SUMMARY OF VIOLATIONS_
Notice Of Violation: glass l andlor. -C /ass l Violations "were found: during this inspection as
noted `in the following Summary of Violations.
The violation's indicated in this inspection report must be corrected within 30 Clays, Unless._
otherwise noted-.
REQUIREMENT FOR :CORRECTION .
Formal enforcement will be initiated for all Class l Violations, and for any Class II Violations .not
corrected within the required timeframe. This report does not represent that there are'no.other..
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violations at this facility. A re- inspection may occur to determine compliance status.
-SUMMARY OF VIOLATIONS_
Item
REQUIREMENT FOR :CORRECTION .
DATE FOR
#
VIOLATION
OF VIOLATION
CORRECTION
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T`) LA's
Inspectors
Received by
Signature:,
Phone:
TPrint Name: r'
Date: - k
TDate:
KPS #8447
White - Business Copy Yellow - Business Copy to be sent in after. Return- to - Compliance Pink - Prevention Services Copy