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O D f 00 6 0. FOODBO NJ Circle designated compliance status IN OUT NIO NIA for each numbered item IN in compliance OUT out of compliance NIO not observed NIA not applicable CI R Demonstration of Knowledge 4 IN OUT Time in Iscor s e serilS RoutiO 3 IN OUT NA GradeA ComPliant wilh the Smoke-Free Illinois Act A. C-. Expiration Date O 1 l OL L Present During Inspection CD - -l9- Original Copy Posted in Facil ity 0E YE YES ITEM OBSERVATIONS AND CORRECTIVE ACTIONS Correct By Item N RI Next...

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