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EMPLOYEE HOUSING PROGRAM <br /> Annual Information Tracking Sheet <br /> Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> Mailed Received �tes of Emloyees Inspection Re-Inspection In ecti Re-Inspection Sample Ye Corrected <br /> 09 ❑ Okay No Yes❑D te: te:� No.: (sc027) (scR27) (yy��c028) (scR28 �(k <br /> Date: <br /> 1` ,f-, ��/�' Date: Date: `�Date* Date: ) fateY� ? � Y 3 /�2 <br /> yip ( r Date: No❑ <br /> cJA <br /> t♦5 <br /> ❑CERTIFICATE of Non-Operation Received Date: ❑CONDITIONAL Permit Issued Date: M REGULAR Permit Issued Date: Z Z Z <br /> Year Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> M lied Received Dates of Empl yees Inspectio Re-Inspection Inspection Re-Inspection Sample Yes E] Corrected <br /> ❑ ❑ kay No� Yes ElIte: Fte <br /> Date: Ds: No.: (sd027) (scR27) (sc028) (scR28) Date: Date: <br /> Date: Date: Date: Date: ( ) <br /> 41 <br /> I j� I A21 ' (sc330) No C/L <br /> ElI Ij <br /> 1LVZ <br /> , <br /> ❑CERTIFICATE of Non-Operation iv Date: ❑CONDITIONAL Permit Issued Date: ❑REGULAR Permit Issued Date: N ZZ <br /> Year Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> Mailed Received Dates of Employees Inspection Re-Inspection Inspection Re-Inspection Sample Yes❑ Corrected <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Okay No❑ Yes❑ <br /> Date: Date: Dates: No.: (sc027) (scR27) (sc028) (scR28) ❑ Date: <br /> Date: Date: Date: Date: (sc303) Date: <br /> (sc330) <br /> Date: No❑ <br /> ❑CERTIFICATE of Non-Operation Received Date: ❑CONDITIONAL Permit Issued Date: ❑REGULAR Permit Issued Date: <br /> Year Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> Mailed Received Dates of Employees Inspection Re-Inspection Inspection Re-Inspection Sample Yes❑ Corrected <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Okay No❑ Yes❑ <br /> Date: Date: Dates: No.: (sc027) (scR27) (sc028) (scR28) ❑ Date: Date: <br /> Date: Date: Date: Date: (sc303) <br /> (sc330) <br /> Date: No❑ <br /> ❑CERTIFICATE of Non-Operation Received Date: ❑CONDITIONAL Permit Issued Date: ❑REGULAR Permit Issued Date: <br /> Year Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> Mailed Received Dates of Employees Inspection Re-Inspection Inspection Re-Inspection Sample Yes❑ Corrected <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Okay No❑ Yes❑ <br /> Date: Date: Dates: No.: (sc027) (scR27) (sc028) (scR28) ❑ Date: <br /> Date: Date: Date: Date: (sc303) Date: <br /> (sc330) <br /> Date: No❑ <br /> ❑CERTIFICATE of Non-Operation Received Date: ❑CONDITIONAL Permit Issued Date: ❑REGULAR Permit Issued Date: <br /> Year Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> Mailed Received Dates of Employees Inspection Re-Inspection Inspection Re-Inspection Sample Yes❑ Corrected <br /> ❑ ❑ ❑ ❑ ❑ ❑ ® ❑ Okay No❑ Yes❑ <br /> Date: Date: Dates: No.: (sc027) (scR27) (sc028) (scR28) ❑ Date: Date: <br /> Date: Date: Date: Date: (sc303) <br /> (sc330) <br /> Date: No❑ <br /> ❑CERTIFICATE of Non-Operation Received Date: ❑CONDITIONAL Permit Issued Date: ❑REGULAR Permit Issued Date: <br /> Year Application Application Occupancy Number Pre-Occupancy Pre-Occupancy Occupancy Occupancy Water Violations Violations <br /> Mailed Received Dates of Employees Inspection Re-Inspection Inspection Re-Inspection Sample Yes❑ Corrected <br /> ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Okay No❑ Yes❑ <br /> Date: Date: Dates: No.: (sc027) (scR27) (sc028) (scR28) ❑ Date: Date: <br /> Date: Date: Date: Date: (sc303) <br /> (sc330) <br /> Date: No❑ <br /> ❑CERTIFICATE of Non-Operation Received Date: ❑CONDITIONAL Permit Issued Date: ❑REGULAR Permit Issued Date: <br /> 11/162017 Employee Housing Annual Information Sheet <br />