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COP,:-.IAT ID: C00039211 <br /> Assigned To EE0005366-MEDINA Site Location: 1110 N MAIN <br /> INVESTIGATION REPORT <br /> Detail all progress report(s)chronologically. List dates,times,types of notices. Describe conditions and actions taken. Attach all pertinent paperwork to <br /> this report. <br /> Date: <br /> Inspector: <br /> Date. <br /> Inspector <br /> Date: <br /> Inspector: <br /> Date: <br /> Inspector. <br /> Date: <br /> Inspector. <br /> omp aint Reviewed by. i^ l ate: Updated by Date. <br /> 5104 rpt 1` �, <br />