|
<br />I
<br />
<br />o
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />(
<br />......
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I
<br />
<br />I .,,_
<br />
<br />o --.---.'-----------.--...,,...;;;
<br />
<br />.. .
<br />
<br />NA"IE OF O' A', .,. Y ~r^ e, ",~rVClr f./."/1/'
<br />I. I'Ir , f--'-' /I i'_'~-'-" - - ..
<br />STATE: eel,?,"",,,,,,?
<br />COUNTY: ic/,,;d ,"'.-cu/;1I.,
<br />INVENTOI1Y NO.: C.? ':~O~'::.;;1
<br />HAZNW CATEGOFi'l: /
<br />TYPE OF Df\M: P.,!I.:~,r i::,;,-i,;.(;//
<br />
<br />O\^n~Ln:;' :,"'11 /2c-:;:"-v(.I;;-.;?;/'~d ,Q('l:JJ CG.
<br />DA Tl, I:,SPECTED: 13 "://'; /?:~<7
<br />VJE..\THEf-l: ::.:'-1"11'1, 0/;;'i
<br />T,::M'LlU,TL'riE: -~,,'."".c
<br />POOL EL r:.'/ ;'.TION: i3 -;;;'/, (; -1-;..... /~/.:;, 1.,
<br />T/.ILv';'i\T[f1 E:LEV/\TION:
<br />
<br />, I
<br />L,'.
<br />
<br />.....
<br />
<br />DIRECTiONS: Mark an "X" ill Ihe YES or t-JO C:l!l'mn.
<br />.'-_., .---~ --. - ----
<br />If In itern dews nut ilpr-1j', writ'; "r~x' i:1 lhl~ nh\1'\rlr~S columll.
<br />
<br />~==,=~:-:~o:~"ITEM, . .;~..c.;: 'lYl:~ '::0 .0 ~;.. ";:~o~i\~4ii':(L~:':,=~.:'~~:~~,~~1
<br />...'.Sfl,E.SL____.__., u_.., .,. ,,-.. I
<br />__=~~~:~ii~~~:;;i,"iI;I:nll'r.:"o-:~=~:=-,-~~--.. - ~'-I?;~:'l' r,:;;'~" 'r ~f.:~,~?~{!~~/;~~:,~,~~::~,_-~==~]
<br />
<br />, c. Cr:1,-:.:~,in9? >".1 ____._..__...__. __~__ J
<br />:2'=U'PS_TREXM~Sc:6j( _" , ______ , __ ,::.:::!t--~ _j _ _ _ __________ __::u:~~:::::"::::..:=_-:-:J
<br />---E__A~"'3~J"'9m""c"ve'O,_______._"___ [,'-:0.."''') ..""-1, --n---:-----n'f--.:;r----------i
<br />__~~~y._~~S~~~I..!.2___._ _ _~______~_~_ _n fl;./-\_-.:'II)}j');:'! ('r) 1:2~.u-r-'!:j(J/ .t....lt...:.:_____1
<br />_ __~_ ~p. _!.r~~ 912'~~n~ 9(\ .,Ioj){::.____ ~_ __ _ __ ___It ;.:: :,~ t _fr.:..J.'!:.. p:.:.JIL.. _tl~;.rj :~ b?t:~ ~(;,r.cJ' 2/ /L~'
<br />__~_:..._(,ngl!l.l_dlll.ll c_r,l'~"" _ __ .___ _ _ _ _ \_:"~I _ -- _ _ --_: _ ---- -.-..--.-- :_- ~-
<br />e Tri..lll$v~rsp ";1,<CI<.,) I";';
<br />''':-_I::A ,J".9U:",~ !.!!'!dP pr""'cll(,~?:::':-: -_-~_~r"':~~",~ I Z~:'-,/;,,!:j r~.::;';/0::i-~ ,;i~',1--':J;'_:f;Y:':L~:"::
<br />~__9._!~..Y_sJ_~n~_d~t~r!oratll)f\ )_________ __n_ _ -l~~ .:-~~ ____ - ~_,!.lr;?-fQ:J.)llt_! ~ /;)6 _C:J"JJ.l:.!.~l c,
<br />___~__~!?~~d_€J~~~,~on_s_ 9r ~~e_~?___~___ ___ -t~ r __ ~- -- _~p~f:~111 ~:_'a~: t)c/Jf~i ------
<br />
<br />.~ ,~ob~ii~~~I~-~:~2~:t:,~-~=-==,~:~ I ~-'.~l:;:::]; ~:_'~L----~,~ ~_= ~-: ~~=___:_=-=_'-'
<br />
<br />___,,'L__j),_, -..-------------'----fX\"'". ~ ,'" --------.. ...---,-
<br />__l'...A_'l}'~'o.s'on?n__' .. --- -.------,...,-I.....,,,,?:'::'l J:1/ ,/)C_. I'/u....'---ruu...'---r;:;,'-..-i-
<br />__.S_'....:~~~_q~_UI..;:)'":~.I~~S ~)fl. ~'!?P.t!)__._._______ ~ T"'-- .I~;:~. -c':::..~,~ :l!.?J.::.JLI .r.:.fI~7:.;!-'C.4--g~-:_-C::r.,t;..~-,J-__-_i
<br />
<br />:..-::f~~2~~~!:f;:)~:~Er~f ~-r-~;~J:I~-~~'?--~~..:~~=~ i .,::, -~~1 ::--:': /{i [:._~:= <;:?J~': (J '?r~r(~~.,tJ .! ~~-=-i
<br />'--;,-...V~;-~;I~~~I~r~~~,'-S" ".L,___.,__ -i' ,- t){: :-~-..-..----_---n--'-_-_-~~
<br />: --J-~~~~~:~~f.~~:,;~jrf~\~;,;~9c~--~~~-~~-=:1;:",~~b~-J:{:,ij::=~~-,.,~':-:~'~~.=~~,..---== ==-l
<br />,. '1~;~r~~~::;:::;",~,,~-~_I.~ ~r,.."^~~v~?~''-~f~;t~~-~J
<br />. .1"~G;~j;~"~:~;'...,~;,;" ,1. .r41, :,!ijD~~;,~~~;::;:;:=="l
<br />
<br />Ll Do C;:I~crc:r' :'lId,I(':~'. :;r~(J.'''' ._<<'.~!I:.--:/j --....----.... 1
<br />
<br />-3~;:i:t;i' .... . ..~~- i... ~1.. .i.'.J-"~;;';)~'2~~~"i:;,;;~~~
<br />
<br />____~l~_ f;~;~;.~~~~f~)r~~! .~;.~-f~t.~--._-~._..,. ]-.-- ~~:~~.t - .---....---..-------~---~-.-_.--. - -------.. --'---1
<br />r.:-- j - p- - .. ,,- - . - --- - ''''_''1_' 't; "'1' --' -- ..n" ---... .......---...--........-.... ..-....--.
<br />1___ b ~~(~ f ~.'~~ ~,~-~;;;~,' ..: ~ ~ -_=:: :: _ ~:=: "-:_-Y~~~I ~_ ;\' 11:::::~_ u_ ::-_-:~:-__=---=-~ =:=,:~::::_=~
<br />[ ;~;'c~~,~~:;~;'~'~r:t,;;~,'::~'i:f..: '....,..--,..-,-_. i'- ..' !;';"1 -.,<-'------- ---..~....-..-----~
<br />__:i31_k,~';~:~~1_=:~,-_:n:'_:---..._=__~_=:: j--_= [~:: i ==:c_==-=~::~_~::':=_-:-~'.~.:::=:=l
<br />
<br />~
<br />
<br />v
<br />
<br />j.
<br />
<br />..
<br />
<br />F
<br />
<br />i
<br />
<br />l,
<br />
<br />~)
<br />
<br />MRO
<br />
<br />FOAM
<br />1 JAN 18
<br />
<br />(1)
<br />
<br />APi'ENDIX A
<br />
<br />1690
<br />
<br />..-.-...-----.
<br />
<br />... .~.. "-' .'. .. ;--\,."., .
<br />
<br />.~._.....,
<br />
<br />.: '; "." '.'~'.'''' ~.~~~.~ .~-".--~ '.-:-. '~:7,;-,~'~ ;:~~.;t~'~:'lZ2.~;iI
<br />
|