HomeMy WebLinkAboutMINOR VIOLATION 10-4-18Owner /Operator: t r 1)'Ef
s
Facility:*
Ad d ress :�� n
Phone:
There were NO.violation s'- observed during this inspection.
Date: -=f
NO
No #ice to Comply: - n-or Violations were found during this inspection as.noted in the following
summary of Violations.
The violations indicated in this inspection report must be corrected wi hin `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.
ct IR MARY OF VIOLATIONS
CERTIFICATION OF RETURN TO COMPLIANCE
certify that the violations noted above on this Notice to Comply /Summary of Violations have been
corrected. 1 have personally examined any documentation attached to the certification to establish that
the:violations have been corrected:
Signature:'
Title:
Print Name:
Date: _
KPS #8446
4. h„ -4- it �f+or Rc +iirn- tn_r'.mmnIinncP Pink— Prevention Services Copy
Received by:..
Print Name: ` /,,I
Inspectors, k
Signature:
Phone:
Date: t
Date: -=f
CERTIFICATION OF RETURN TO COMPLIANCE
certify that the violations noted above on this Notice to Comply /Summary of Violations have been
corrected. 1 have personally examined any documentation attached to the certification to establish that
the:violations have been corrected:
Signature:'
Title:
Print Name:
Date: _
KPS #8446
4. h„ -4- it �f+or Rc +iirn- tn_r'.mmnIinncP Pink— Prevention Services Copy