Laserfiche WebLink
M -1977 -075 <br />Consent Agenda Form <br />October 24, 2014 <br />Page 3 of 3 <br />Operator(s) Signature: <br />By signing this, the Operator agrees to the stated violation and will comply with the Corrective Action(s) and <br />Civil Penalty outlined above on the Staff Summary Form for Consent Agenda Items. <br />jda�_4 .............�. ^.1..._...... - IJ...._ ..._._..� <br />it or Sigi ire Date Notary P blic <br />'01 \iUl6kC�� ;;ua;������ My Conunission expires: <br />Nom'• '�VBLlC ': <br />9j•' pO ���` <br />F co <br />n �O COL�PP ®r <br />