HomeMy WebLinkAboutBlackburn Elementary Kid Connection 420097 12 12 11. LS.pdfKC, Depwrivmt, of Environment and 1,41t" R murcts D,,,erlt, 0 Health Depailment 18
Divmn ofEnvironmental Health,
Sanitation Standards Evaluation Date of Insp/C,11.g Cur Facility 111) 2018420097
or ror Child Care Centers
Steals Code� A Old Facill ty Ili
classifIvatioll [ESuperior ElApproved 0 P—r—oVi—si—o—n—a—l—ODis—approved Water SaM pie taken todar, [:]Yes [E No
Water snppl)- gcornmuntty lNon-TranSWilt NOA-COMM, unity [Dlnspp-'Pi.ntlon Name Change
nTraslonl Non-Commundon-ub y NPlic Water Supp�y Re-jn:o�Ver fication of C losu re
ED Vr$it Status Chinge
Wastewater System: c ommunity [E0 ri-stte system
Licensing ID No. Maximum capacil'y 0 Comment Sheet Attached OYes RNo
COMMUNITY SCHOOLS
Nwoe of Facilay: BLACKBURN ELF M KID CONNECTION Operator:
Street Address, 4377 W NC 10 HWY
city, NEWTON staftNC zip� 2=
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*M Meftaboris preper�, stored
*29. Hazardous products proper� stored and �ocked CR 6 1 nvironm ent, H
Anvow Ris form ii wed to �Wemtt G 8 I 10V rpquiinq 6w tare tentm to, s4fflk e4dence of tme&" sa?AA on %tarl&r& in Ph"vog ipw An* M-W an
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Ein-umawn4l 1b a1th SerAm Sec 6= (RoNiv w ?M
N.C. Department of Environment and NaturM Peso
Name: BLACKBURN Eta KID Time In: 1 E] a rn
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Division of Environmental Health
[D. t1 Time Out: 0 a am
Stre et' 4377 W NC 10 HWY Total Time- I mpminuto
WOMEN=
General Comment? L]Yes