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NOTICE ISSUED: Yes: No: Location'-OeAT ( Np *t,) Kego f2,( L Date Received Responsible Person: Address: r2-6 i�P�tAI /%cld(L� Nature of Complaint: -Tke i\n -T)OGr- 5t"13 ffikv -41) pjakfS(Q> Reported By. 12Acgl Address:' Date of Investigation: Condition Found: Inspector: Action Taken: gg�U�asm5p -ME7 xggr-sl- j� 0 c PH UT 7we7 MlSslKG 51G+ -N5. I Peso No-Vjfr-i0 1�&I KAL, CaNYT(00 U �T PKR26�-s 12? e-'J%02JG; JOG -,S, A.(L�1s0�' OGGtk7 6Is -M OLAW Hance Date: Notes: