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Epide�aotogya�dEav�Aeahh 1"�/Y��V <7CQiL�■ A��Y VO�C��
<br /> '• 1011 Soudt Firsc Street,SmLe 215
<br /> . H°,�,�55��-�'3 Inspection Report
<br /> {952}930-2770 FAX:(952)930.2?82
<br /> �]: ' ' m�.ns IiC 11113-1(3J0
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<br /> idame: It1t��' C3�:�%.�J ��h�!'i ��rJ��,� ��{s Date: �_" �""f�..�.�� Pa�e: , af __.__._.
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<br /> Phone: �o9ram Etement: ._----___._ �
<br /> Routine ❑ ComplaiM t7 Plan �
<br /> inspection Type:�. ,_. o Foifow up ❑ Consultation r�Other: �,,�'��'���vt. L�'� 1 �_
<br /> Sased on investigation this day,the items below identi�rfy the vio(atior�s,whid�must be oortedsd by such period of time as specified
<br /> below. Failure to compiy within the time specified for correc�ions ordered in this notice may resuit in further actron by this Departrn�t
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<br /> !f you have any cp�estions concerning this�eport,ptease� �����.���- ��- �
<br /> Received by and � .� � Health Authority/ ��'� ,� -
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<br /> diswssed with `''`� /" � ,`� �t�,�:�.,f � � MsP�' � i l��_ <�.� ,�-�-�
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