HomeMy WebLinkAboutFood Service Establishment Inspection 59 (6) Pagel of
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INSPECTION REPORT STATE OF CONNECTICUT
FOOD SERVICE ESTABLISHMENTS DEPARTMENT OF PUBLIC HEALTH
CONTINUATION SHEET
NAME OF ESTABLISHMENT TOWN DATE OF INSPECTION
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INSPECTION REMARKS
FORM#
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INITIAL(INSPECTOR) INITIAL(PERSON IN CHARGE) Y\
Distribution: Ist-White-Health Department 2nd-Yellow- Owner/Manager