HQS Extension Request

HQS EXTENSION REQUEST

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Address Inspection Occured(Required)
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Individual Requesting Extension:(Required)
I understand that this request must be completed and submitted seven (7) days prior to scheduled inspection. Verbal extensions will not be approved. Extension requests will not be approved for life threatening violations requiring corrections within twenty-four (24) hours. Section 8 HCV
*Length of extension will not exceed 60 days