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Human Services and Public Health Department
<br /> ' Epidemiology and Environmental Health Public Health and Safety
<br /> Hennepin 1011 South First Street,Suite 215
<br /> Hnopkis,Minnesota 55343-9413 Inspection Report
<br /> (612)543-5200 FAX:(952)351-5222
<br /> e-mail:epi-envhlth@co.hennepin.mn.us P§1/11 -fi 121e:rt) h
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<br /> Name: Lallo 5-tgi--/ . t,,i A13, i Date: , - — Page: of I
<br /> Address : g 110 n , attop /vi) Inspector: rwi F O.,..c
<br /> City, St., Zip: i3Ofr),(j tta te iv/ Location:
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<br /> Phone: Program Element:
<br /> 0 Routine Complaint 0 Plan
<br /> Inspection Type:
<br /> 0 Follow up Consultation 0 Other:
<br /> Based on investigation this day,the items below identify the violations,which must be corrected by such period of time as specified
<br /> below;...Failure.to comply within the time speciled fir corrections ordered in this notice may result iiyirt,h9r action by this Department.
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<br /> If you haveany questions concerning this report, please contact (..,,v I 4- ' i ' , _...),--- / •
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<br /> Received by and .2. ) c_._. ,..-- Health Authority/ i A, ,
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<br /> discussed with ..- -dr----- e---- .':-.------- - Inspector-/-a itC/2(f , „(, - .-.7:, -:-.1---5-:-.
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