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f III IIIIIIIIIIIII III <br />COLORADO DIVL8i01~1 Ot I~RAi3 APID GfA1.04'Y <br />•~ NAt~: Cad Rime ADDR F88: rm Sbver t Anoeia(a <br />OlERA1VR: NCIG Fiooid 2768 Caopus Drive, Stine 101 <br />rBl(1d7I7~: NCIG Frail <br />ODUNTY: G <br />li <br />W Goad laaotioa, CO 81306 <br />ar <br />e <br />TYPBOFOrBRATION: BURFACB [AVDF2 [iROI1ND X LOADOUT <br />OWNIDtS1I8: Fl;i)>~tAL NON-F I3~AL X <br />!'SRINIT STATUS: IN ~o-Aa~a AP-eppie.ro^ i A.Y:w, 00-[Jtlr C~ Qidr. IN-i~aYw~Pa~r~t <br />CaulioS AV~teroloed, S[J-8~p~ds1, 7C-T~y C~ria~. OR•O~~r <br />Ci 1tQde ID OR E)fPIARATION ID NO. C ~ 84 065 <br />[C] Qi8lBCl'ION DATB 29 ! ltaJr / 2001 <br />[c] arsrECt+o~e nrrrlAls a a w <br />[CJ Tam OF DAY (!IDl'fARY T11~ 10 15 <br />[CI EvsrECl~oN Tyre CODB c r ~ <br />~~ <br /> A~ arsar op..ro <br />r(1BP IIiSPECi'ION OON1'ACTS N O NO-Nora Hl.-U®1~. c8D-u~8 Cap. at' <br />~ <br />DB ~ <br />~ <br /> CTfi~S C1 <br />~7ii~ <br />S. <br />B <br />]OWf INSPECT. AI[iBN(.7 OODB N O D1v-U8 Ml01~~ FSi7s. Pam 3avoti <br /> a~ D~pf, oe~R S~Swe <br />E~er(Wr,rlt~as) <br /> ~ <br />C~~ <br />REASON POR INSPECI70N C0~ S R ~ ~~~ <br />~ <br />~ <br />l <br /> <br />' aa, ON-0S~l NfJN 1 ~~Ow~ <br />F <br />o <br />~~f~M-1'h*riai~/ink <br />~ <br />OOllrANY 1tBPItBBEDTfATIVE r1(BSENT <br />Ns <br />CO. REP. 810NATURE (~FffiD 18SUANCE ONLY) (D~re) <br /> <br />II~ECIDItB SI(1NATUREJl~~.~ /f /~ /~ ~ Z /----Lo*1 ~ ~) <br /> <br />[CJ wBATHHR CODE CR CL~Cbudy. CR-Cba. FG~Foppy. RN~Rakdrp. SN~Srawkp, WD~Wlndy <br />INSPBCI70N RHp'ORT 188UANCE DATE <br />N048: [Cl-Arpi~e+y <br />Mi!<IE - Fb <br />Pn~oc - Sp.orw <br />I~ ~ of ~~a. (date) _t! drw 1001 ~ (initialer) '~^~ <br />