HomeMy WebLinkAboutBlackburn Elementary Kid Connection 420097 05 22 14.ls.pdfN.C- Deprtnent ofEn,.ironnent and Natual Resoirces D em ch t 4 Health Departm ent 18
Division of Envirotunmial �kalth
Sanitation Standards lEvaluadon Date of lnspChg 0 5 1 2 a / .1 0 1 4 Ct=ent Facility ID 2018420097
Form for Chid Care Centers
Status Code, A Old Facilit�, ID
Classification- [Esuperjor DApprovea 1-1 Water Sample taken today? DYes [j] No
WaterSupply- [j]Community ENon-Transient Non-Conimunity Rinspection 1:1 Name Change
Z Transient Non-Cornmunity ONon-Public Water Suppty MRe�nspectton Verification of Closure
Wastewater Svsteur: Community n-Site Systern [:Ovisit Status Change
M TO H
Licensing D) \o. M aximu rn Capacity 0 Comment Sheet Attached [:] Yes No
Nameoffacility, BLACKBURN ELEM KID CONNECTION operates.. COMMUNITY SCHOOLS
Sheet Address: 4377 W NC 10 IC City� NEWTON stat,�c zip: 28658
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N,C. Department of Environment and Natural Resourses NameLACKBURN ELEM KID Time In: 0 3 0 6 []am
CONNECTION L—J---JEE P M
Division of Environmental Health ID: 2018420097 Time OuL L 13 E 1 1 15 fDam
Street: 4377 W NC 10 HWY Total Time: 9 minutes Pm
COMMENT ADDENDUM
PW NEWTON
General Comment? E]Yes
G. Department of Enviranment and Natural Recourses
Division of Emronmental Heafth
Nij,rT-- BLACKBURN ELEM KID
CONNECTION
2018420097
Street 4377 W NC 10 HWY
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