Assistance - Template

Site Name:

Address:

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County:

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Zip:

Directions:

Section:

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Assistance ID:

Staff Assisting:

Program Type:

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Action Date:

Report

Attached Files/Reports

File Name	File Type	File Date	Note

Comments

Date	Comment	Commenter
3/13/2017	The owners information was updated to reflect Travis West as the single owner of the facility. Information was obtained from the Adams County Assessor to verify the ownership. A request was sent by Becky Sexton to update our records. The request is documented in the file.	WENDY WITTROCK

Assistance Details:

Field Office Compliance - Assistance