HomeMy WebLinkAbout Word of Life Academy H Sheet 420128 05 01 17.LS.PDF•Malmomsam
Establishment ID: 2018420128
11 inspection El Re -inspection
0 Visit
Date: 0 5 1 0 1 1 2 0 1 7
Status Code: H
Category . NIA
County: 18
Catawba Zip: 28658
U Name Change
Email
WastewalerSystem- 91 MuniCipaUCOMMUnity Cn-Sna System
Ej Status C ha Inge
Time In: 0 4 d 9 0 am
0 Pm
Water Supply:
EM MunicipallCommunity On-Sitp System
0 Pre -Opening Visit
0 am
Permittee-
BRENDA ROBINSON
Time Out: 0 4 3 5 0 pm
Teleph one:
(828) 466,-0897
0 Other
Water Sample taken? Dyes [:]N,,
Total Time, 6 minutes
Temperature Observations
Item
Location Temp Item
Location Temp Item
Locaticin Temp
Observations - Corrective Actions - General Comments I
CLOSED
*GC
First at
Person in Charge (Print 9 Sign): First Last lk
LUKE SEARS
Regulatory Authority (Print & Sign):
REHSID: 1896-Sears, Luke REH ontac hone Number:
North Carolina Department of Health& Human Services 9 130sion of Public Health 9 Enviro Pmental Health Section 9 Food Protection Program
'A DHH S is an equal oppoaunity employer
T, I'S Page 1& 9 Food Establlighment Inspectinn Report, M013 A