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BLAINS 15SU RC S AVE';UE vV-ELLjM A-X -rSPECTION CFM •� <br /> SAM JOSz.CAUFOFIN1A 9S i12 <br /> TECH S�NI�-- (¢ae)5T:3-=, s 1 FAX X71 ���T <br /> (403)!57, PHONE CIie:1t ,NOr 7 <br /> Se Adt�Te�a � O <br /> T ecrintclan <br /> +� r <br /> c fJrr��yy 1 .6r, Date <br /> -BMs pp.�Y <br /> I Lia an box? 6 Casrna se—wire12 Water stamina in veibcx7 1E 'Nell r--a funczcna17 <br /> 2 Lid broken 7 7 Ca_srna rat fele% 123 St�raina grove the too of cas:na7 16 Can=0 be puffed loose,2 <br /> 3 Ltd baits missma 7 a 0eons in weiftox 7 17-b SMnorna belum the too of c:asrno7 17 Can c.;n sear outwmLr7 <br /> 4 Lie baits sffropea': 8 Wer[box is too fa ; ave oraoe 7 12c Water even wi h the tou of r_;s,ng: 113 Paalodt present? <br /> 5 Lid seal mr=cr7 110 We-Tbax rs tco tar teas araae7 13 Wefl cau present%' 19 poofock funcscnai7 <br /> 11 'Meflbax is aysaedidamaaea% 114 Well=found secrre7 <br /> 0 Check box if no deficiencies were found. Note below aefclencles you were aole to correct. <br /> Weil LD Defc.ency Corrective Aaron Taken <br /> i.aeat 4- I �c &( <br /> I � <br /> f <br /> I � <br /> I � <br /> I <br /> I= -1 <br /> a <br /> I <br /> t`lole beraw all t3e'1encles 111;51 could not be corre--leo art❑ still nem 10 be correc'1ed <br /> BTS Office ass.ans or Dale Dale <br /> 'Neil I D Pers,stma Derlcienci defers Correction to assicned corrected <br /> I <br /> f <br />