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� f <br /> TECH 8LE1T11=— SAI I JGSc.CALI1=ORMIA 95112 <br /> - pjat -�:4 1 FAA Cilerit <br /> �,t-��1d �•1QBt sTa-95ac I7HC�rlE <br /> Sale Address '7710 <br /> r � <br /> Technician <br /> Date ! - 31 . O t <br /> 111dnn bnxr' 6 Casma Gyrei 12 WELT SbMU7ng in-Veflb3x: 19 Well C-.a furrconrmii <br /> LEd brnlcerti L'�Ino cut lees! 12g-SUmd nn Ecave the too nt Arno i 16 Can=p be puffed loose' <br /> 3 Ud balfy ms-,mu', S. Qebris rn uellbox i I2b_St-Rnoing belrrm the top of 1::!.—frro7 17 ala rip seal out viater� <br /> 4 !id buffs stripped', 9 'Nelibex is ten far above areae? I Zc Wafer wren rrrir the tap of casing i 18 FaaIoc';present i <br /> S Ltd seat int.-cC' - IQ Wellbax Is lou Far taekrry grads' 13 well cm prF---rri t 19 P-mlocit lunctarrai i <br /> 11.'Melba.-is rntshexYdamaned-, 114 Well=found semirs 7 <br /> 0 Check box If no deficiencies were found. Note below deficiencies you -Here able to correct. <br /> 'Neil I.D. Deficiency Corrective Action Taken <br /> I <br /> i <br /> I <br /> Pole below all defienctes [hat could not be corrected and still need to be correc-fed. <br /> BTS Office aSSIans or Dale Date <br /> Well I D Persisting Deticienc-i defers Carremen to asmaned corrected <br /> I I <br /> I � I <br /> t <br />