11 Complaint Record 8/22/12 BOARD OF HEALTH
CITY HALL
COMPLAINT RECORD
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6omplainant: ULYs,w Inc*?
Name of
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Address'
Tel:
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574- 315-7,0
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Location:
Owner:
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Taken by:(i I
Date 6�i z/u2
Time:Z. 0”
INSPECTOR'S REPORT:
Oynm Pimia,.i Ta cMcF Box BYES
Total#of Inspections: Orders Issued?:
Date of Final Inspection: Notice of Compliance?:
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Inspector Signature
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MESSAGE
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DATE TIME 11 .
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CELL
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,ti'MLIELEP
RETURNED YOUR CALL
PLEASE CALL
WILL CALL AGAIN
CAME TO SEE YOU
WANTS TO SEE YOU