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F-fd41 (rev.0901) <br /> Wisconsin Department of Agriculture, Trade and Consumer Protection Wis.Stat. ch. 97, <br /> Division of Food and Recreational Safety Subch. Ill Wis.Adrrnn. Code <br /> PO Box 8911 Madison, WI 53708-8911 ch.ATCP72 <br /> . , Phone:(608) 224-4682 Fax: (608) 224-4710 <br /> LODGING ESTABLISHMENT INSPECTION REPORT <br /> ESTABLISHMENT NAME LICENSE TYPE LICENSE NUMBER <br /> Loon Landing at Benoit Lake Tourist Rooming House ATCP-053591 <br /> ESTABLISHMENT ADDRESS LICENSEE <br /> 26596 Loffgreen Rd 33469 County Rd 373A, LLC <br /> Spooner,Wl54801 ATCP-L52069 <br /> ESTABLISHMENT ESTABLISHMENT EMAIL LICENSEE ADDRESS <br /> PHONE <br /> dustin.dale@haywardrentals.com 376 JJ Kelly Rd <br /> (715)638-0417 Lyons, CO 80540 <br /> INSPECTION DATE INSPECTION TYPE FOLLOW-UP REQUIRED - TYPE FOLLOW-UP DATE <br /> 05/30/2024 Administrative Follow-Up NO <br /> COMMENTS <br /> This was an administrative follow up for no water test. Operator sent sanitarian a passing water test. License is to be released. Use this report as <br /> your license until the actual license arrives in the mail. <br /> OBSERVED VIOLATIONS <br /> For detailed code language regarding violations, go to:ATCP 72-Hotels, Motels, And Tourist Rooming Houses <br /> Yoursignature on this form acknowledges receipt of the inspection report, and is not an agreement with the findings. Signing this form is <br /> voluntary. Personally identifiable information you provide maybe used forpurposes other than that for which it was collected. Wis Stat <br /> 15.04(1)(m).Any operator aggrieved byan order of this department under this chapter may request a hearing as provided in Wis. Stat ch.227, if <br /> state licensed, ora local ordinance, licensed byan agent health department. <br /> G� <br /> Image Pla hdder <br /> PERSON IN CHARGE SANITARIAN - Alex Hintz <br /> Public Health Sanitarian-Advanced <br /> alex.hintz®wisconsin.gov 1 (608) 977-0242 <br /> Page 1 of 1 <br />