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HomeMy WebLinkAboutPermit Field Test & Inspection Report 1980-06-18OKEGON STATE HEALTH DTVISION Department of Human F- Jrces INSPECTION REPOU i NAME. ADDRESS:q rk-.| ,n ,LL j n.nJ. INSPECTION DATE rrUR NUMERATS tlXE THIS + YR.MO. DAY l_M { h0l, INSPECT TRAVEI- TIME tl SANT. NO. CLASS TIME SUPT. OR LICENSEE FAC. TYPE CTY. NO GRADE UNITS 6b.5 ESTAB. NO ESTAB. TYPE VIOLATIONS aaD 2 3 q /,{ 0 ?2 ,/)/o I I I I I I I II I I I I I I II I I I I I I I I I I I I I )) I I I I I I I I I II I I I AN EVALUATION OF SANITATION ON YOUR PREMISES HAS THIS DAY BEEN MADE AND YOU ARE NOTIFIED OF THE DEFECTS ENUMERATED BELOW. VIOLATIONS ENUMERATED ON THIS REPORT MAY RESULT IN DENIAL, SUSPENSION OB REVOCATION OF A LICENSE, CERTIFICATE OR PERMIT. OAR/ORS SPECIFIC PROBLEM {'^/- , .: 1 fatr 7 K'-G Rsr-o 4-,-; b oL?Jo Alo /,7or,r., Ep. r ns-,< 2*, ?;;fir. 6o "a6z:*--< .f r r.rz-2/ 4z.uu , Pozn,u,*ur-o -&ro n ,y'".z.-, E-.e<rrze - A,/a 2a* ^, Anz<dt-a Ma sr€P rtL REQUIRED CORRECTION & TIME LIMIT {.,r' J : : i .... SANITARIANIOPERATOR WHITE: OSHO FILEi YELLOw: POST lN ESTATLlSHMENT; PINK: cOUNTY FILE / SAN{ 0l Rev. 6 -7 8 g P o aq 4 e"x*-,, 7.fur7t-t* ilt*rr.,