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TEST DATE_____________ TECH_____________ EXPIRES_____________

TEST DATE_____________ TECH_____________ EXPIRES_____________. PHONE 314-845-7778 (Form 012) Rev.00. Document Name: Inspection Sticker Page 2 of 2 Document Number: Form (012) Revision: 01 Originator: Anne Waddell - CBIL Date: 1/3/01

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TEST DATE_____________ TECH_____________ EXPIRES_____________

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  1. TEST DATE_____________ TECH_____________ EXPIRES_____________ PHONE 314-845-7778 (Form 012) Rev.00

  2. Document Name: Inspection Sticker Page 2 of 2 Document Number: Form (012) Revision: 01 Originator: Anne Waddell - CBIL Date: 1/3/01 Approved by: Paul Hebenstreit Date: 1/9/01 HISTORY PAGE REV.: 01 APP. DATE: 1/9/01 ORIGINATOR: Anne Waddell-CBIL COMMENTS: History page added to document approval signatures. Since this is a purchased item, current inventory which does not show form number may be depleted. Next order of this label will use the artwork attached to this document. ______________________________________________________________________________ REV: COMMENTS: APP. DATEORIGINATOR 00 Original Document 9/22/00 Accurate Superior Scale

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