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(Page 2) Q~~ <br />F` ~~ # - ~ <br />INSPECTION DATE: ~- Z ~I' 9 9 INSPECTOR'S INITIALS:_1ZL <br />OBSERVATIONS <br />~/2 i s Pro~osDe,~' e~ er~f ~o+~ i S f~1'" 3 0 ~0 7~e 2 ~,p,0%Ga-wI S ~ l e-y,. ~p t~e~e~~ <br />5 p~ ~11e ra~~ e~/~r~/. a ~d f~C /~ %(/ ~ p <br />of ~t J'/tc~ S/~ted' ~~~1 ~o~~e~r A721Ktrl~gifel~ ~/ ~~-w~lc ~Z SG1 <br />Colercc~o ft~~`ti~ ~.~ ~ rCSi~~~~~urlrLCSI/irQ/~~/~f~t~P~/` <br />pp <br />a i- ~c e ~r ~r o Go ~d)"-QOcb SDIy~-5. <br />~e~jrn~~s~~ a~~ess ro~~ iis~i~l~lf ~ ,~ glj-~~~ gUPS ~aa a <br />sa~er~~ cff~~revf ~i~ ~ Grbssef a f"re~b~~~~ U ~ f-o 9~~-Cre~li- ~C <br />Qr~u-~ `~cL ~~rr~-~ t Cjri.t~j~~. cc <br />talri S!~'f/~ !'~: {/ se~~1. 7'J.~-P cr~G2sg aQ~` es~-7~-i /Lr-~ ~1~/~of <br />j'~r~Yf ~ ~Q vN- ~ f1 n,~ f ~ ~ e <br />/~/` ~vY~Gl- /~ /'`2 -~ L~a ~ "e ~__//~.J/0 Gf~ a~ceFS y~o~~l~lP~C ~yolf/N~q <br />GN'~dJL ~~ G/2GSe ~ !O GJOfj /(~2 G/'Z°Y/[~ S//KCB /~ wt~j ~t/LU/o(/ <br />Sf~2~ TU o~d,~-e G~ ®~ 7'-~e ~~~evc~. -~sf~~, w~~Q~ele~ <br />~rrr~os~~~-,/f ~j fvr - f~~ef ~s /T-~q-D~G7 ~~f~~~d7~ <br />ftj-k c fay-ef w2>~ ~~ ~- ri/- n. e ~,~ I r~ e ~~av'ofc~r <br />OY-~t, . <br />~ ~ yX~j-y~tc~- ate- ~~ /S / J ~ ,-~~,~ /~ v~v-~duf r~~~f <br />y'G~e /~f G~~~~ f`prE~,( r'n~~ e,~iS~ vh- ~rPvrouf ~r v.-~or~s~`~-~ <br />f' -~ <br />I & E Contact Address <br />NAME: cc: ^ CE <br /> ^ BL <br />OPERATOR: ^ FS <br /> ^ HW <br />STREET: ^ HMWMD (CH) <br /> O SE <br />CITY/STATE2IP: ^ WQCD (CH) <br /> ^ OTHER <br />