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HomeMy WebLinkAboutDAILY INSPECTION REPORTS - MULTIPLE RESTAURANTS - MAY 2020INSPECTOR'S DAILf REPORT Res'taurant -_Day Care,-_Foster Home -_School --Compl~l.int:' ,-Septi c Tank __VA-FHP.-Conv.---Ylafer Sample __Food Sampl e:__ Food Handl er1s C1 ass Educational Coourse ,Seminars -- " Swimrrii ng Pool s ~Iater &.Sewer txams '.Vector Inspections _ ,Comments:-----------_~--__-Other:----------------- PERSON/PLACE ,CONTACTED:.','-,.',...,."...' INSPECTOR'S DAILf REPORT ·ADDRESS:' CHECK ONE:PRELIMINARY INSP.','FOLLOt-/.:UP INSP.'__.,-----:--- .•".••.•..••.•-••.•.•.•.•.•.•.•.•.•.•.•.••.•.••.•.•••..••.••.•.•.•.•.•.•.•.•.•.•.••.•.••.••.•.•.•.•.••.••.•.".••.•.•.e'••• CONSULTATION ~ Res'tauran,t ~Day Care __Foster Home --School --Compl a,int : ,- Septi c Tank __VA-FHP.-Conv.--Ylafer Sample __Food Sampl e:__ " Food Handl e rls C1 ass Educa ti onal Coourse Seminars -- " Swimrriing Pools Water &.Sewer txams 'Vector Inspections ,Comments:--'-_Other:---------------- INSPECTOR'S DArL~REPORT .PERSQN/PLACE CgNTACTED:~Wd ..~ ADDRESS:.....:..:',Li2[D.L:~d'l,dgtl-?~···~··uP '..'. CHECK ONE:PRELIMINARY INSP....FOLLOt,/.:.UPINSP.'CONS'ULTATION / ..~.':~::~'~,. 'J-,J...••~_•.._•..Res l..aUran,I..Day Care Foster Home .School Campla.lnt. ..- Septi c Tank __V.~-FHA-Conv •--Wal_'er Sampl e __Food Sampl e _._... Food Handl er's Cless Educational Co'urse .'Seminars -- Swimrrii ng Pool s ~Iater &Sewer Exams '.Vector Inspections ~ .Comments:u_LV 0)\CLL------~~~~~---Other~--------------- INSPECTOR'S DAIL~REPORT DATE:.~-----------INSPECTOR: .---:---__ .PE~5QN!PLAC.~.Cq~TACTED:_ .ADDRESS:._.~_"----.:_____:___.._..___:__;.:___-'----,-_ CHECK ONE:PRELIMINARY INSP •...FOLLm/.:.up HfSP.'--CONSULTATION...................................,". Res'taurant '.--Day Care __Foster Home --School --Campl il.iilt:. .- Septi c Tank __VA-FHP.-Conv.--Wafer Sample __Food Sample' Food Handl er's Class Educational Co'urse Seminars -- Swimrrii ng Pool s ~13.ter &Sewer Exams .Vector Inspecti ons .Comments:Other~------------- " INSPECTOR'S DAILY"REPORT DATE:"-----:-'_s~II~1W~r\1J)~,' .PERS~N/~L:GE CONTAC~ED:••4fa~fud ~:fucb ADD~c:SS~,,.,",',','U 3Z/L ·S,n \dQ;/--(b'lC-Ltf' CHECK ONE:/~~:~~~:~~~:.~~:~:.~.•.:~~~~:/~~~.:~/:~:••.••..•••C~~~~~:~~.:.... Res'taurant 'Day Care Foster Home 'Sc-hool Compla.iilt:', ".-- INSPECTOR Septi c Tank -_VA-fHP.-Conv.--Wafer Sample _'_Food Sample_'_ ,, Food Handler's Class Educational Co'urse '"Seminars -- Swimming Pool s ~Iater &.Sewer txams ''Vector Inspections _ Other:-----------------,COrruTIents: INSPECTOR'S DAILY"REPORT 5\\\tuLDDATE:,_~--~~~---------- PERSQN/PLACE CONTACTED:....~,~~\,h,lic1\.~~v.~.. ADDRESS:-Li6W :~W ~~ INSPECTOR:c::G~1\YQ_ ,--:-----__ CHECK ONE:,1Mi,NARY INSP.""FOLLot-J.:.UP HfSP.''CONS'ULTATION ~.--_"~............................''-'',.,',',,' Day Care Foster Home 'School Compla.iilt : ".--. Res'taurant -- Septi c Tank --VA-fHP.-Conv.--Wafer Sample __Food Sampl e _._, Food Handl ert s C1ass Educational C~urie Seminars -- Swimming Pools -_Water &.Sewer txams 'Vector Inspecti ons __--~:b\Iclo'){ci Other:------------------,COrruTIen ts: INSPECTOR'S DAILY'REPORT PERSQNIPLAC~,Cq~TACTED:,~G I ADDRESS:'?3HD '4 J«(1,n,v;\(\,,',' CHECK ONE:PRELIMI.NARY INSP.','FOLLO[-f.:UP INSP.'CONS'ULTATION L Restaurant /oa;·~~:~~~~~~:.~;~~~~~;;;~;~;~;~~.•............, Septi c Tank -_VA-FHJl,-Conv.--~lat.'er Sample _'_Food Sample_'_ ", Food Handl e rl s C1ass Educa tional Co'urse ',Semi nars -- Swimming Poo1s Water &Sewer txams 'Vector Inspections __ ,Comm=:n ts:---->.o<:0-.:::L-=--L~rb=--S.L_·..LI.\(1...&....£l1o~.::_;.,_Other;--------------------- INSPECTOR'S DAILY'REPORT •ADDRESS: CHECK ONE: ,PE~SQNIPLAC~,cq~TACTED:,----=-)__:h~6-~~-'----'-'5~,tJ~Rr=:'-..,,-..,-'_"_,_,-:-','_,_'_"_,_,:'LtG-tr ..S'(\lcL~lIJ?I!Q\?1?UP, PRELHlINARY INSP.'__''FOLLot-J.:UP INSP.,CONS'ULTATION ~ /"..','--:--.,._.._____'.._',.___.._.,'",__._'.',,' Day Care Foster Hom.e "School Compl a.iht :__,Restaurant "-_ Septi c Tank -_VA-FHJl,-Conv.--Wafer Sample --Food Sample'-_ Food Handl e rls C1ass Educa tional Co'urse Semi nars -- Swirmriing Poo1s Water &Sewer txams 'Vector Insp2ctions ,Comments:-------------~-------Other;-------------------- INSPECTOR'S DAILf REPORT ;::::;:~LACE CONTACTED:,(~q~\~~t -1M1 clu1ed / CHE CK ONE:?~~:~~~:.:~:~:.::::-:~~~~:/:~~.:~[:~::C~~:~~:~::~~.~.. Res'taurant Day Care Foster Home 'School Compla.int:' .".-- Septi c Tank __VA-fHA-Cony.--ylat,'er Sample _'_,Food Sample~ ...\ Food Hand1 erls C1ass Educational Co'urse ',Seminars -- Swimmi ng Pool s ~Iater &.Sel'fer txams 'Vector Inspections _ ,Comm~nts:----------------~-----Other:--------------------- INSPECTOR'S DAILY'REPORT DATE:;,_,..,-.,__~~,''-+-l \~)UJL-=-.____:',,-0__-_ PERSQNIPLACE CONTACTED:·..~L~v:ri,W?-:.. ADDRESS:'",',',',',',,llC{'\3:t!\\:t{LJrq":":,"LLP CHECK ONE:PRELIMINARY r~sp.'__''FOLLor'/~UP INSP.'_ -,..,',"'"'".. CONSULTATION R::s'taurant -_Day Care __Foster Home --School ---Compla,i nt : ,- Septi c Tank __VA-fHjl,-Conv.--Wat~er Sample __Food Sampl e' ", Educational C~urse Seminars __Food Handler's Cl2.ss Swimrriing Pool s ~Iater &.Sewer txams 'Vector Inspections __ (amments:CW X01G(Q,-\)1,15111 In l)~~VI r ~C'rll{'rL)._. DATE::.......-:--.-5~1--l_1~IW~LD=--- PERSON/PLACE ·CONTACTED:fuWe.!) ADDR~SS:',.....'-.....-.-------'-=U-·'.-,{2-r=-"=f::::"__J-·j."-II-I'L-({-_/~-±-""-"'{-AR-'c''. INSPECTOR'S DAILY.REPORT CHECKONE:/~~~~:~~~:.:~~~:.~•••:~~:~:I:~~.:~r~~:~C~~~~::~::~~..< Res'taurant "Day Care Foster Home .School Compla.int .''. Septi c Tank __VA-fHA-Conv.-_ylat_'er Sample __Food Sampl e _'_ Food Handl e rl s C1ass -_Educational Co'urse Seminars -_ Swimmi ng Pool s piater &Sel12r Exams 'Vector Inspections ,Comments:(LA v-b~idL 't-CPv11it,(o~---,--::------:_ L,)\vxl (\~__j = INSPECTOR IS DAILY'REPORT DATE:.:;,\II'LUZD INSPECTOR:nall',5a PERSQN/PLACE CONTACTED:~D\tlt.<?CYbDdQVD ... •ADDRESS:...•....•ill\S SV1\iJl'/:C>k'lJo-uP .._/' CHf;CK ONE:PRELIMINARY INSP..'FOLLOt-I.:.UP INSP.'CONSULTATION ~.-,,'---:----- ..~~:..,"",'"".'""".'.'. Res'tauran,t "Day Care Foster Home ..School Compla.int :___, Septi c Tank __VP.-fHP.-Conv.__Wat_'er Sample __Food Sample_'_ Food Handl er's Class Educational Co'urse Seminars __ Swimming Pools Water &Sel12r Exams 'Vector Inspections __ ,Comments:-_;O~4"~~j:_/')--'--_-_-'--_Oth~r:-------------- INSPECTOR1S DAILY"REPORT DATE::.....-.;-.-~-tI_S-t-I{__ou~'~D:..._____ PERSQ NIP LAC~.Cq~TACTE D;._-,--_H'--"-'-Lt;:;:l.....:....h.=o:&'-'='C_,__,VL'-'-O -=-_ .ADDRESS:._._-'----'----.:..____:_..•_.~~"O"q_'~...L-\':..!__V:::...J..d~·~LL..l{\D~~~-=-·._...:'_.._."--:-'-·.t,L.:lt~e-·'-~"_,...---.:..__:. CHECK ONE:PRELIMI.NARY INSP...FOLLO[-/~UP INSP.·CONS'ULTATION~ /.".-:---...................................,............................................. Res'taurant '.Day Care Foster Home School Compl a.iilt.'. .- Septi c Tank __VA-fHA-Cony.--Wat,'er Sample _._.Food Sampl e _'_", Food Handl e rl s C1ass Educational Co'urse ..Seminars -_ Swimrriing Poo1s plater &Sewe.r t.xams .'Vector Inspections-- .Comments:±ft9a1 \1At -' au t:,\~51<'.-1\r Other:-------------------- INSPECTOR1S DAILY"REPORT .;:;:~;;~LAGECONTACTED~51~~~E1~~nenuP ..' CHECK ONE:PRELIMI.NARY INSP •.__.FOLLotr·up INSP.·.CONS'U LTATI ON / Resta ura nt ~~:::~~~~:~.~~::~~~~~;~~~;;~~~~.=.~.. Septi c Tank __VA-fHP,-Conv.--Wat,'er Sample _Food Sample_'_ ", Food Handl erls C1c.ss Educational Course Seminars -- Swimrrii ng Poo1 s Water &Sevle.r t.xams .Vector Inspections __ Other:-------------------__ INSPECTOR'S DAILY'REPORT ADDRESS: CHECK ONE: ",.~0i6Rb\Zr~tt~~t~~. PRELIMI.NARY INSP.''FOLLOt-I.:.UP H[SP.'CONSULTATION ~ PERSON/PLACE ,CONTACTED:...'-..'.. -:--••,'•••.••••••••••••••••••••••••••••••••••••-••••••••••••••••••••••••"'"•,'•.••••'to •••••"•••••••'••• Res'taurant --Day Care -_Foster Home -_School --Compl2l.i 11t .'' ,- Septi c Tank __Vi\-FHA-Conv.--Wafer Sample __Food S2mple~ Food Handler's Class Educational Co'urse ,Seminars -- Swimrrii ng Pool s -_Water &Sew~r rxams 'Vecto~Inspections C.L l J t:...1--'/,{I,r::/1 J-'"-'r '"rlvc.,':1--,omme n LS:_--40--\..ol.l....:-e:::__!,_~C~wL_~U=~=<:lo.L!_Jv:_____r_\'lCH"'Mh~ INSPECTOR'S DAILY"REPORT DATE::'__';---,-,~=-?::-+-l S_'4-hP..::::.-,,_'_W,_INSPECTOd8~ CHECK ONE:PRELHiI.NARY INSP.'FOLLOt-I.:.UP H[SP.'CONS'ULTATlON ~ Restaurant ~a;'~:;:~~:~:;.~~~:~~~~~;.,,..~~~;~;~~.=. Septic Tank -_VA-FHp,-Conv.--Wafer Sample __Food S2mpl e _._ ", Food Handler's Class Educational Co'urse Seminars -- Swimrrii ng Pools Water &Sewer rxams 'Vector Inspections __ ,Comments:S~ud V----TC{,hSJ / Other~------------- INSPECTOR'S DAILY'REPORT DATE:~,--_o~ls;_.J...I~....I.<::{l...L'-JU):::.lo.c·INSPECTOR: PERSON/PLACE ,CONTACTED:....,".,.--:----'e=A.!.L-'--""'~-i---""'""""-!..~~=-----__ ADD~ESS:~~-~-~~~~~~~~~_.~~~.~.' CHECK ONE:PRELIMINARY INSP...FOLLOl-/.:UP INSP..CO!'{S'ULTATION ~ ..~::::'"..':~.. 'J-.:.....~n_k.,...."-......,Res l,.au_ran_L Day Care Foster Home .'School Campia.lnt .. ...--, Septi c Tank -_VA-fHA-ConY.--lh(er Sample _._.Food Samp12_'_", Food Handl er1s Cl ass Educational Co'urs'e ,Seminars -- ,Comments: Swimmi ng Poo?s ~Iater &Sewer txams '.Vector Inspections _ S~ll icmp!~-..~her;----;.----,--'__ ------~·~~Q~~~±~~~~~v+~~~~h~k~~~.~-d~~-v--------- INSPECTOR'S DAIL~REPORT DATE:;...__..,-,_--=-5+--'~,...-L-h.;___~_o INSPECTOR:d9ru 11'i,~ Septi c Tank -_VA-FHp,-Conv.--Wa(er Sample --Food Sample' 'i Food Handl er1s Class Educational Course Seminars -- Swimming Pools ~Iater &SeHer txams __ ......---.. ,Comments:l:'a ~~~~'L...@ Wcl0LrPther;~~""---r--:--~-T=-~,._ INSPECTOR1S DAILY'REPORT DATE:.<s \s I'LO'LD ::::~;tACE C9NTAC~ED:.tf ~~~;iilib1t[,._till ..,. A:~:~~~:.:~~::.~;..:~~~~~/~~:.gr~~::C~~~~::~::~~.~ Day Care,Foster Home ''School Compla.iht:,' .,.-- Ylater'Sample Food Sample:____ ...\ CHECK ONE: Res'taurant -_ Septi c Tank __VA-FHA-Conv.-- Food Handlerls Class 'Educational Co'urs'e ',Seminars -- Swimming Pools Water '&Sewer txams .'Vector Inspections _ .Comments: .---.',--_--- INSPECTOR'S DArL~REPORT DATE:,INSPECTOR:~ .PERSQN/PLACE CONTACTED:'.'ff;l~'..'. 's·..11"",;,,,~,ADORES:"...'-LJ:>··'.•.;vS =VI 9--- CHECK ONE:~PRELIMI.NARY I~SP.'_,'FOLLO[-J.:.UP ~~[SP.','CONS'ULTATION ~...........-'.......... ... Res'taurant "Day Care Foster Home 'School Compla,int.", .."--'- Septi c Tank __V.l\-FHA-Conv.--h'at_'er Sampl e __'_Food Sampl e' Food Handler's Class Educational Co'ur'se 'Seminars __ Swimrriing Pools ~later &Sewer t.xams "Vector Insp=ctions _ .Comments:O\)b\do~d I{\Iild 0/dQYDther:_ O\lh l dR_'L)ia:i L'td::; INSPECTOR'S DAIL~REPORT DATE:;,____.,-,_5--t\---,--\3--...L)_1£JL_,_0_,_ ADDRESS:-~~~-~~~'~'-'-~~~~~~~~~-u~~~==_~~ CHECK ONE:PRELIMINARY INSP.CONSULTATION --:--.••0'.••.•••••.••.•••.•.•.•.•.•.•;•.•••.•••••.••.•.•••••.•.••.••••'"••.•,••,'•.••.•••.•','.•••,',•• Restaurant --Day Care --Foster Home --School -_Compla.i n t .' ,- Septi c Tank --V.l\-FHJl.-Conv.--~lat_'er Sample --Food Sample_'_ ", Food Handl er's Cl ass Educa ti Dnal Co'ur'se Seminars Swimmi ng Pools -_Wa ter &Sewer t.xams 'Vector Insp=cti ons __--cd 1011 tf:d ')(~c Other:-----------------__,Comments: INSPECTOR'S DAILY'REPORT DA TE:'--'-----'=9~1f--L-1~""'-41__l<_7u=-.!._·1u=-'._ PERSON/PLACE ,CONTACTED:......"... ADDRESS: CHECK ONE: Res'taurant -_ Septi c Tank __VA-fHA-Cony.--h'at_'er Sample _'_Food Sampl e ~ ", Food Handler's Class --Educational Co'urse Seminars __ Swimrrii ng Pool s plater &Sewer txams __'.Vector Inspections ~ ,Comments:C,;{A.:VbS 'j GLL<Other:--------------- INSPECTOR'S DAILY'REPORT INSPECTOR: Septi c Tank __VP.-fHP.-Conv.__h'at.'er Sample __Food Sample_'_ Food Handl er's Cl2.sS --Educational Course __'Seminars __ Swimrriing Pools '.Wate~&G~~w~rtxams .I "v,":~a)r~nSP"ctions.__ ,Comments:~\V\~Nk'u.(I"YJ~(CI \ILJtn~__+--_ L = DATE:~._S__,_I_l Y...!..-l--l _:::_:W=:.____=G....:::=_O_ INSPECTOR'S DAILY'REPORT PERSQN/PLAC~.Cq~TACTED:'=D_--LX_1m_ut-=--<._ ADDRESS:.__~.'-bIlLJ.......LS-uU......LS _"tfw...·'.!_..Ld ..Il.C:WIod..·"-"":..L-\t._:_·,.L...:.OO.l....lo.i··:!C....,..<'-.._····_,'_..-_.·-hi!Lll.....l--e-·.___:.__-'.___.:___:. CHECK ONE:PRELIMINARY INSP ..CONSULTATION Septi c Tank __VA-FHP.-Conv.--!<lat_'er Sample _._Food Sample:___ Food Handler's Class -_Educational Co'urse .Seminars Swimrrii ng Pool s -_Water &Sewer txams __.'Vector Inspections _ .. ,Comments:--~W~·.....:...\5L-·.L.I1coALL..!!=::;_.S....,l.l{.3lI.N-J.D...!..lr...l.J..._Other:------------------- INSPECTOR'S DAILY'REPORT PERSON/PLACE·CONTACTED: ••--•0'".' ADDRESS: CHECK ONE:: Septi c Tank _V.A-FHP.-Conv.__Wat_'er Sample __Food S2mpl e _'_ .; Food Handl e rl s C1ass Educa ti onal Course Seminars __ Swimming Pools Water &Sel'r2r txams .Vector Inspections __ Other:----------------_.Comments: INSPECTOR'S DAILY'REPORT DATE::..._."___,;'5~''_'1+.-I'W_YL_O_ P ERSQ NIP LA C E ,Cq~TA CTE D:,_-,--.__._C.-<-~_,_(~-d-'>(.•...•.O..:...,___...,O_"__"k,-,-/I-.l'{___.,l _ ADDRESS:,:.___':.___"_-l..C/o.ctU~··...L.:3D!>L..:.·~._',_,_:S",J-...J··{-!...:.'\':'1-=,dL::::..:__~v_2fu:~.~;m...l..:..c',<~;..~u~i? CHECK'ONE:'PRELIMINARY INSP.__FOLLOl-/.:.UP HfSP.'CONS'ULTATION ~."-....,;,....................................... Res'taurant .Day Care Fost::r Home .School Campla,int.", ..,-- Septi c Tank __V.t\-fHA-Conv.--~lat.'er Sample _._Food S2mpl e ~ ", Food Hand?er's C1ass Educa ti onal (o'urse Seminars -- Swimming Pools ~Iater &.Sewer txams 'Vector Inspections_ ,Comments:Other:------------------- INSPECTOR'S DArL~REPORT PERSONIPLACE ,CONTACTED::]?L '~H(QJtL".....•.',....,.--:--------L---D~.....,._~~..__.___,-....=.._':::t:::::=-"'------:-:-----:-- ADDRESS:~_',._',:~Le....-Lru-=:'-I.,....._.._·SL.!-h-,-,-,>'ctkio<..=·'=--10<:>--,-Y,--,k9~1U--"_."---tf-"iA""'t-P-..__ CHECK ONE:PRELIMINARY INSP •.·FOLLOl-/.:.UP INSP.'--CONSULTATION Res'taurant "-_ ~',/'-..'',',','. Day Care Foster Home'School __Campl a.int .' .,---. - Septi c Tank __VA-fHp,-Conv.__Wa(er Samp1::__Food Sampl::_'_ Food Hand?erl s C1 ass Educational (ourse Seminars -- Swirmiing Pools -_~13.ter &.Sewer txams 'Vector Inspections __ ,Co00::n ts:--------"O""-l'f<=."'-'/(\'--__0the r:_ DATE:'--:-'_1_',---J\t--l_c{~l ~:::__O L=:..._-D_ ,l ::::~;~~LACE .CONTACTED:-.,..----;-'.-K-,.oo-=-c-'~~_'_S-v-+~_'_'_'~"""':"c4:....:..oM""'~4"'-'-,.~...~-}§._-.-..-.-"'-L-L-f?. CHECK ONE:PRELIMINARY INSP...FOLLOtf·UP HfSP.,CONSULTATION ~-- Restaurant ~.~~;~•.•••":~~~~~;.~;~~.•••.•..~~~~;;•.••....~;~p;~;~~.::.....~..-_.,,-- INSPECTOR'S DAILY'REPORT INSPECTOR: Septi c Tank __V.L\-FHA-Conv.--Wat_'er Sample __._Food Sample' Food Handl er's Cl ass Educational Co'urse .Seminars -_ Swimming Pools Water &Sewe.r txams ..Vector Inspections .Comments:~J\\\-\t:rY'I P cl uWOther:_ INSPECTOR1S DAILY'REPORT DATE:~.~_INSPECTOR: .~ PERSON/PLACE·CONTACTED: ..............--:-----------:-------:-:----:-- ADDRESS ~.._.,_-----~---------------------------- CHECK ON~:PRELIMINARY INSP.-•••••••••••••••••••••~••••••••••••••••••••••••"••'"••'••••.,••••••••'t •• .FOLLOl-/.:UP INSP.·---CONSULTATION Res'taurant '.-_Day Care --Foster Home -_School ---Compl2J.i nt : .- Septic Tank -_V.ll.-FHP.-Conv.--Wat_'er Sample ---Food Sample_'_ Food Handl er's C1ass Educational Co'urse Seminars --- Swimming Pools ~Iater &Sel'rer txams .Vector Inspections __ .COl11Iil2 n ts:Other;--------------------__ IN5PECTOR1S DAILY"REPORT DATE:,51l'-1 \1OW INSPECTOP.:\~llla PERSON/PLACE CONTACTED:.dCoall1=:\b(ll'ldovO'. ADDRESS:"".'",":.~.,'~'(£0\::)S r\\cUv7~-uP CHECK ONE: Septi c Tank __VA-fHA-Conv.--14at,'er Sample _._Food Sample_'_ ", Food Handl erls C1ass Educational Co'urse ,Seminars -- Sl'!imrriing Pools -~Water &.Sewer txams __'Vector Inspections __Urt,n '£)1 ?jQ~C Other:------------------ ,Comments: IN5PECTOR1S DAILY'REPORT Septi c Tank __V.L\-fHP,-Conv.--14at,'er Sample --Food Sample_'_ Food Hand1 er1s C1ass Educational Course Seminars -- Sl'!imrriing Pools ~13.ter &.SeHer txams 'Vector Inspections __ .Comments:~1/J Oth,r:_ INSPECTOR'S DAILY'REPORT DATE::....-,-._S--,--I_(q~(~~Qz:...l-L()_ PERSQNIPLACE CONTACTED:.Sbovt .S ~P ... ADDRESS:..{)1(.J "Sn i eLI-·f)2 kt1a.-'Ll£ CHE:K ONE~../~~~:~~~:.~~~~:.~:~::~~I:~~.:~I:~:c~.~:~::~::~~.~ Res (..auran (..Day Care Foster Home School Campla.int :' "'.-- Septi c Tank __VA-fHA-Conv.--\tlat_'er Sample __Food Sample_'_ '; Food Handler's Class --Educational Co'urse Seminars -_ " Shl'imrriing Pools ~Iater &Sewe.r txams 'Vector Inspections ,COIT1li1ents:~v ~7»)clt 'd-n~v.--r-Other:_ INSPECTOR'S DAILY'REPORT Res'taurant "-_Day Care __Foster Home -_School --Complz!.int : ,- Septi c Tank __V.t\-fHP.-Conv.__Wat,'er Sample _'_Food S2.mple_·_ '; Food Handler's Class Educational Course Seminars -- Swimming Pools Water &Sewer txams 'Vector Inspections __ ,COIT1li1en ts: INSPECTOR'S DAIL~REPORT DATE:~,-Sl""-"i'!-+-'l ~+-t-'I~=ow=_,_ PERSQNIPLAC,~,Cq~TACTED:"k IlW ''lD=xu k.t;, ADDRESS:"-(;iQ<S5·'"~fJdl"cLL~t,~·'-'l{p ,",' CHECK ONE:PR~LIMINARY INSP.'FOLLot-J-:,UP H[SP.,--CONSULTATION -,.-_,.""'........ 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