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_ SANm� �A n� � Environmental Health Department <br /> - MUM Co+ rie Action Statement <br /> RF— AUgMt 14.2024, i L peCfi a report <br /> Fos eaCh vy0fMt7r1 IMWd below,mndre t ff Ole VKOatian lras bum caorreded or mil be csnz-ecw by a cedaln date- Also, <br /> desanbe u tal was done to carrel Me violabon in We space provided below each vioiatinn- Submit this completed farm <br /> vAlh the Return Co Un4kance CeAffication wW in 30 days of alWCAW. ff you have any questions.plea"conlacl <br /> LYrmey 5anonons all 1209}616-3057 at LsanbvonsGsjgov.ofq <br /> ?ACLS BILE AWME T. 2"W 110RDdiI+ibC WAY,CELS ID. 10190779,PRO231137 <br /> VwdaWa#12-704 --Secondmy corer runent test rww is wAW&+M to Me CUPA within 30 days attar the <br /> test <br /> f.3-'Thft kAmOm ...td (3 Tsxs vk0abon wM be COFMCted by KW*�- <br /> (71 Sam dMVMWft im <br /> foie ad Xff15 tak.M OF bre t #CWTed WGJ eX <br /> 0 j <br /> r -22nma-spa t) s-4Yrg.ate swhmmind ec URA=Mkhm-V duygr-gmv. <br /> r- 1FM!5;w(MWfam=36 CCV=b3i 0 Tbft wwaeami wo be comcmd bw 4° k <br /> 4 d=--f <br /> take`Cr we Le t�bz!a ez;^ ,.Ee- z <br /> 1�. <br /> � & <br /> 1 I <br /> ins us-'-t l2 ti3e4 0 <br /> x <br /> �.,. Pane 3 of 3 <br />