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, <br /> ���,�„ INSPE�TiON REPART <br /> � <br /> � �,d.�:s����� �`�.et�r..� r�-�'c , <br /> co.,na�a�,�� , ��—.�—�.�� <br /> Ownrr �jyr3r`^ ___ <br /> / <br /> / <br /> fai�o___'__�. __". __�---_-'--- <br /> ._"__.._ . ._ ._. . _ _ . . .. _ . . <br /> TYPE Of INSPECTION REQUESTED <br /> �-) 131.DG Pmt. Nn��� � �� MECH: Pmt 170 __ <br /> I.1 f.LK' Pmt. Nn— �] FLBG: Gmt. No__"__—_'_'_ <br /> � 1 �{��usin9 ; i Muv,nry � J Insulali n <br /> [] locrtinp (] FmminB (� Gn.undwnrl <br /> �] Fnundalinn all tJoi6n9 � � G�n,ultah <br /> I1 �rw<r (] Hruph-In (-� final <br /> I 1 f�r��pla<e and ChimnrY 11 S�rvirn, f_I Othrr'_. . <br /> � .. - . . .�, �_.._ . . ..__ _-. � _" ..___ ��__�" _ ",.:_..- _ . _ <br /> �APPROVA� ( ] PAPI "L ;"��'PROVAL <br /> I1 VIOLl�TION �_] CORRErTICN RC.(�UIRfD <br /> _ _ , ___- <br /> �-j C��necl�ci�s lisrcd Ldnw MUST UC MADE 1�I �rr w��< <.. � . � .� . �. <br /> [) Wark lisled bel�:w hos bcen impecled anA appmv�d <br /> [I Pleau conlact msP�cto� and ononpe (M ePPoinfinent <br /> �.I Wos not able tu perlurm im.pe<Ilon. <br /> ( I ���L Y59�BB70 POR REINSP[CT10��: � 2� h�vr n.�i��� ��� :�� �� � <br /> 4 (:i.iplicnlr ul Ottupanp� 5hnll bc iswcA anJ yuslrJ on thc prcinisci prior fo x[upan�f. <br /> ���_��4 <br /> "____'-_'__"_"—__ �__ _.. � _- . _.___'__'_.,_-A'_". . ... <br /> ImP�c����i�_� .. . I�:1�� .'/��A/-�. <br /> �✓� / <br /> � <br />