HomeMy WebLinkAbout4800 fairfax violation 6-28-13SUMMARY OF VIOLATIONS
Item REQUIREMENT FOR CORRECTION DATE FOR
# VIOLATION OF VIOLATION CORRECTION
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Inspectors
Signature:
Notice Of Violation: Class Nand /or Class C Violations were found during this inspection as
noted in the following Summary of Violations.
Phone: 32r.� —
The violations indicated in this inspection report must be corrected within 30 days, unless
Date:
otherwise noted.
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
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
ti ,r 1 ;c ;✓t"C� > .J� t!� s�c'i✓` !`E�l s/i aJ.'rlrr
S a: 144n
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Inspectors
Signature:
Received by : - -- -' ..
Phone: 32r.� —
Print Name:` .. ,. ak
Date:
Date: _
KPS #8447-.
White — Business Copy Yellow – Business Copy to be sent in after Return -to- Compliance Pink - Prevention Services Copy