NY State - Food Service Inspection Report
Form Template
This form is an electronic version of the New York State Department of Health - Food Service Establishment Inspection Report, Simple Version, DOH - 192(2/98), Subpart 14-1.
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This form records basic identifying information about a food service establishment (e.g. a restaurant) as well as any violations by the establishment found during the course of inspection. This form does not record in detail what has been established; the main focus of this form is to record violations.
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