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. ' . <br /> Name of Facility: <br /> iMy / i1City: I O <br /> Owner/Operator: Telephone 1:%�, <br /> Program Element: Program Record: Inspection Type; <br /> _.u. <br /> 98180 Posted Yes No Permit Posted Yes No Re-inspection on or After: <br /> OBSERVATIONS AND CORRECTIVE ACTIONS <br /> n. <br /> RW4 Wu <br /> : "�7 r L <br /> WIN W11 <br /> L <br /> r i <br /> ■ M4 <br /> iI J/ % ♦• /a : ./��/si[� .� <br /> 1 <br /> X ;1 '.��i_. LYAWI <br /> Item Location <br /> Exp.Date: <br /> ,Received By Title: <br /> 401 AEH Specialist:' PagV <br /> �.�3 /.. <br />